Incidence of aspiration pneumonia during hospitalization in Japanese hospitalized cases did not increase whereas concern factors were exacerbated in a time-dependent manner: analysis of Diagnosis Procedure Combination (DPC) data

Abstract

This study aimed i) to investigate about items with high relevance for aspiration pneumonia during hospitalization among cases evaluated using Diagnosis Procedure Combination data, and ii) to determine whether the concern factors for aspiration pneumonia during hospitalization were exacerbated with the trend of the time. The Diagnosis Procedure Combination data were gathered from 2010 through to 2015 with 63,390 cases at Saga University Hospital. The occurrence of concern factors of aspiration pneumonia during hospitalization were compared in the two time periods set (2010–2012 and 2013–2015). The concern factors included: male, age, dysphagia at admission and during hospitalization, use and days in the emergency care unit or high care unit, use of the intensive care unit, and use of an ambulance. Age, dysphagia, and use of the intensive care unit were time-dependently exacerbated. The incidence of aspiration pneumonia during hospitalization in hospitalized cases did not differ between years 2010–2012 and 2013–2015. Aspiration pneumonia during hospitalization complicated with surgery and number days in the emergency care unit or high care unit diminished in years 2013–2015. Despite an increased concern of aspiration pneumonia during hospitalization, the complication rate of aspiration pneumonia during hospitalization did not increase.

Risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients: a retrospective study in Japan

“…The low serum albumin level, an indicator of malnutrition, ( 17 ) was applicable for evaluation of the disease prognosis including the patients with severe sepsis and percutaneous endoscopic gastrostomy. ( 18 – 20 ) Several reports showed that serum albumin levels were associated with mortality and/or prognosis of the pneumonia, ( 4 , 21 , 22 ) which was consistent with the result of the present study. Several indicators including procalcitonin, ( 23 – 25 ) which was not evaluated in the present study, might be applicable for evaluation for prognosis of the pneumonia.…”

“…( 3 , 6 , 12 ) Whereas several studies suggested the several risks for community acquired pneumonia including aspiration pneumonia, the reports which demonstrated the risk factors for prolonged hospitalization and patients’ prognosis of the disease were limited in Japan. ( 4 , 6 , 13 , 14 )…”

“…Introduction C ommunity and hospital acquired pneumonia is still one of the major lethal causes in Japan, especially in aged generations, (1)(2)(3)(4)(5)(6)(7) whereas several preventive medical practices including vaccination for pneumonia have been performed. (8)(9)(10) In aged populations, majority of community acquired pneumonia might be caused by aspiration and/or dysphagia, which might lead to a high recurrence rate and poor prognosis of the disease.…”

“…(8)(9)(10) In aged populations, majority of community acquired pneumonia might be caused by aspiration and/or dysphagia, which might lead to a high recurrence rate and poor prognosis of the disease. (2)(3)(4)6,11,12) In a real world clinical situation, definition and diagnosis of aspiration pneumonia and/or community acquired pneumonia have not been well-established and therapeutic approaches might be the almost same between aspiration and non-aspiration pneumonia. (3,6,12) Whereas several studies suggested the several risks for community acquired pneumonia including aspiration pneumonia, the reports which demonstrated the risk factors for prolonged hospitalization and patients' prognosis of the disease were limited in Japan.…”

“…(3,6,12) Whereas several studies suggested the several risks for community acquired pneumonia including aspiration pneumonia, the reports which demonstrated the risk factors for prolonged hospitalization and patients' prognosis of the disease were limited in Japan. (4,6,13,14) The present retrospective chart review in the Japan single institute in aimed to reveal risk factors for prolonged stay and mortality is newly hospitalized community acquired pneumonia patients more than 75 years old in order to take steps for medical care for aged pneumonia patients. In addition, the present study examined if swallowing ability was related to the repeated hospitalization of the pneumonia patients.…”