Risk factors for recurrence of fever in aspiration pneumonia

Background: Aspiration pneumonia is common in the elderly, and recurrence of fever is often observed after remission. Recurrence of pneumonia extends hospital stay and impairs ADL of patients. However, few studies have focused on recurrence of fever in the course of aspiration pneumonia. Method: Patients who had been hospitalized with pneumonia in Ono Municipal Hospital from June 2002 to December 2012 were enrolled. Patients were prospectively evaluated for aspiration risks based on clinical history such as neurological diseases, bedridden state, oropharyngeal or laryngeal disease, gastroesophageal disease, ileus, nasal gastric tube or tracheostomy holder, use of sedatives or hypnotics, subjective or observed aspiration, vomiting episode as a trigger of pneumonia, alcohol abuse, and psychiatric disease. Those who had at least one of them were defined as aspiration pneumonia. Recurrence of fever was defined as body temperature (BT) >37°C after once BT had decreased under 37°C. Results: Of 767 patients who were hospitalized with aspiration pneumonia, recurrence of fever was observed in 157 (20.5%). Mean duration of hospitalization was 29.9 days. 30-day mortality was 8.9%. The number of aspiration risks was between one and seven (mean 2.3). The number of aspiration risks were significantly associated with recurrence of fever, duration of hospitalization and 30-day mortality (p Conclusion: Having multiple risks for aspiration accelerates recurrence of fever, and significant risk factors for recurrence of fever were revealed in this study.