Factors associated with the incidence of aspiration pneumonia during hospitalization in older adults admitted for non-respiratory diseases in an acute-care hospital: a retrospective cohort study.

BACKGROUND

Aspiration pneumonia (ASP) during hospitalization is associated with poor patient outcomes. We examined the factors associated with ASP onset in older patients in an acute-care hospital in Japan.

METHODS

This retrospective cohort study analyzed data from the administrative claims database of patients aged > 65 years hospitalized and discharged from a general acute-care hospital between July 2016 and March 2021. We conducted multivariable logistic regression analyses to identify factors associated with ASP incidence, with independent variables including sex, age (65-74, 75-84, ≥ 85 years), place of residence before admission, income, main disease causing admission, dysphagia at admission, Barthel Index at admission, Charlson Comorbidity Index (0, ≥ 1), Hospital Frailty Risk Score (0-4, ≥ 5), presence of rehabilitation services, surgical treatment, planned hospitalization, enteral nutrition, and total parenteral nutrition.

RESULTS

The ASP incidence during hospitalization among the 11,504 included patients (mean age 81.1 years) was 1.6%. ASP incidence was associated with female sex (adjusted odds ratio [aOR]: 0.451, 95% confidence interval [CI]: 0.326-0.625), age ≥ 85 years (aOR: 2.901, 95% CI: 1.471-5.718), dysphagia at admission (aOR: 3.810, 95% CI: 1.410-10.293), low activities of daily living level (aOR: 0.971, 95% CI; 0.963-0.979), comorbidities (aOR: 1.839, 95% CI: 1.298-2.605), frailty (aOR: 2.918, 95% CI: 2.089-4.077), unplanned hospitalization (aOR: 3.068, 95% CI: 1.593-5.906), and receiving rehabilitation services during hospitalization (aOR: 0.435, 95% CI: 0.256-0.739).

CONCLUSION

This study identified the factors associated with ASP onset in older patients in an acute-care hospital in Japan. These findings may help identify older inpatients who are more likely to develop ASP, supporting the planning of targeted care strategies during hospitalization.