Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia

Abstract Objectives Aspiration pneumonia is a leading cause of death among older patients; however, little is known about the long-term mortality in aspiration pneumonia. The purpose of this study was to evaluate long-term mortality and its associated factors in patients with aspiration pneumonia. Design Retrospective cohort study. Setting and participants In total, 550 patients with aspiration pneumonia (median age: 78.0 years, 66.4% male) with compatible clinical symptoms and chest computed tomography images were enrolled at a single tertiary center from 2006 to 2016. Measures The 1-, 3-, and 5-year mortality rates were evaluated for all patients. The prognostic factors for 1-year and 5-year mortality were also evaluated using Cox proportional hazard models. Results A total of 441 (80.2%) patients died during a median follow-up of 50.7 weeks. The 1-, 3-, and 5-year mortality rates were 49.0%, 67.1%, and 76.9%, respectively. Multivariate analysis identified 5 risk factors for 1-year mortality of male sex [hazard ratio (HR) 1.533, P  = .003], low body mass index (HR 0.934, P  = .002), hypoalbuminemia, anemia (0.973, P  = .032), and mechanical ventilation (HR 2.052, P P  = .371). Conclusions/Implications Long-term prognosis of aspiration pneumonia was poor as a result of underlying morbidity instead of the aspiration pneumonia itself. Our findings suggest that prognostic indices for patients with aspiration pneumonia including the patient's underlying conditions should be devised.