Mortality from Aspiration Pneumonia: Incidence, Trends, and Risk Factors

Gupte, Trisha; Knack, A.; Cramer, John D.

doi:10.1007/s00455-022-10412-w

Cited by 46 publications

(41 citation statements)

References 15 publications

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“…The mortality rate of patients with aspiration pneumonia is higher in comparison to non-aspiration pneumonia. Recently, Gupte et al [5] reported the burden of mortality from aspiration pneumonia in the United States, with an average of 58,000 deaths per year. The authors also reported 76% of the deaths related to aspiration pneumonia occurred in the group of adults aged ≥75 years old.…”

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confidence: 99%

Aspiration pneumonia

Niederman¹,

Cillóniz²

2022

Rev Esp Quimioter

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The growing population of older people worldwide represents a great challenge for health systems. The elderly are at increased risk of infectious diseases such as pneumonia, which is associated with increased morbidity and mortality related mainly to age-related physiological changes in the immune system (immunosenescence), the presence of multiple chronic comorbidities, and frailty. In pneumonia, microaspiration is recognized as the main pathogenic mechanism; while macroaspiration which refers to the aspiration of a large amount of oropharyngeal or upper gastrointestinal content passing through the vocal cords and trachea into the lungs is identified as “aspiration pneumonia”. Although there are strategies for the prevention and management of patients with pneumonia that have been shown to be effective in older people with pneumonia, more research is needed on aspiration pneumonia, its risk factors and outcomes, especially since there are no specific criteria for its diagnosis and consequently, the studies on aspiration pneumonia include heterogeneous populations.

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confidence: 99%

Aspiration pneumonia

Niederman¹,

Cillóniz²

2022

Rev Esp Quimioter

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“…We consider that poor oral health in nursing home residents has become an important health issue worldwide 20,22–25 . In the future, as society ages, the number of older people, including nursing home residents, with pneumonia is expected to increase 5,12 . Therefore, we should pay close attention to oral care in nursing homes to prevent pneumonia and maintain good oral health among the residents.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10] Aspiration pneumonia is a subclass of pneumonia and is associated with a higher mortality rate than nonaspiration pneumonia in older adults. 6,11,12 Nursing home residents often have comorbidities, such as cerebrovascular disease and impaired consciousness, and are more likely to be diagnosed with aspiration pneumonia. [4][5][6][7][8][9] Nursing home residents also have poor oral health because of the difficulty of accessing professional oral care and their functional disabilities in performing their oral care.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness of professional and mechanical oral care for preventing pneumonia in nursing home residents

Okubo

Hoshi

Kondo

2022

J American Geriatrics Society

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Background Pneumonia is common in nursing home residents and is a leading cause of hospitalization and death. Nursing home residents with cerebrovascular diseases and impaired consciousness are at high risk of aspiration pneumonia. Professional and mechanical oral care by dentists and hygienists in addition to daily oral care by caregivers was shown to be effective in preventing pneumonia in nursing home residents. However, professional and mechanical oral care has not been widely provided in Japan, while daily oral care by caregivers has been widely provided as a basic service in nursing homes. This study aimed to evaluate the cost‐effectiveness of providing professional and mechanical oral care for preventing pneumonia in nursing home residents. Methods Using a decision tree and Markov modeling, we conducted a cost‐effectiveness analysis from the payer's perspective (social insurers and patients) in Japan. Results The incremental cost‐effectiveness ratio for professional and mechanical oral care compared with daily oral care only was calculated as 4,079,313 Japanese yen (¥; 33,994 United States dollars [US$], US$1 = ¥120) per quality‐adjusted life year. Conclusions Using the official value of social willingness to pay for a one‐quality‐adjusted life year gain in Japan of ¥5 million (US$41,667) as the threshold to judge cost‐effectiveness, providing professional and mechanical oral care is cost‐effective. Our results suggest professional and mechanical oral care for preventing pneumonia in nursing home residents could be justifiable as efficient use of finite healthcare resources. The results have implications for oral care in nursing homes both in Japan and worldwide.

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“…Dysphagia, or swallowing dysfunction, occurs secondary to a variety of illnesses, disorders and traumatic injuries that disrupt the well coordinated mechanism of swallowing. Dysphagia is a primary cause of aspiration pneumonia which is associated with higher mortality rates than non-aspiration pneumonia [1] , [2] . Swallowing impairments that lead to dysphagia are usually identified by the temporospatial kinematic analysis of videofluoroscopy (VF) images to determine the severity of the underlying condition and the best course of intervention [3] , [4] .…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

Khalifa

Mahoney

Lucatorto

et al. 2023

IEEE J. Transl. Eng. Health Med.

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Objective: Dysphagia management relies on the evaluation of the temporospatial kinematic events of swallowing performed in videofluoroscopy (VF) by trained clinicians. The upper esophageal sphincter (UES) opening distension represents one of the important kinematic events that contribute to healthy swallowing. Insufficient distension of UES opening can lead to an accumulation of pharyngeal residue and subsequent aspiration which in turn can lead to adverse outcomes such as pneumonia. VF is usually used for the temporal and spatial evaluation of the UES opening; however, VF is not available in all clinical settings and may be inappropriate or undesirable for some patients. High resolution cervical auscultation (HRCA) is a noninvasive technology that uses neck-attached sensors and machine learning to characterize swallowing physiology by analyzing the swallow-induced vibrations/sounds in the anterior neck region. We investigated the ability of HRCA to noninvasively estimate the maximal distension of anterior-posterior (A-P) UES opening as accurately as the measurements performed by human judges from VF images. Methods and procedures: Trained judges performed the kinematic measurement of UES opening duration and A-P UES opening maximal distension on 434 swallows collected from 133 patients. We used a hybrid convolutional recurrent neural network supported by attention mechanisms which takes HRCA raw signals as input and estimates the value of the A-P UES opening maximal distension as output. Results: The proposed network estimated the A-P UES opening maximal distension with an absolute percentage error of 30% or less for more than 64.14% of the swallows in the dataset. Conclusion: This study provides substantial evidence for the feasibility of using HRCA to estimate one of the key spatial kinematic measurements used for dysphagia characterization and management. Clinical and Translational Impact Statement: The findings in this study have a direct impact on dysphagia diagnosis and management through providing a non-invasive and cheap way to estimate one of the most important swallowing kinematics, the UES opening distension, that contributes to safe swallowing. This study, along with other studies that utilize HRCA for swallowing kinematic analysis, paves the way for developing a widely available and easy-to-use tool for dysphagia diagnosis and management.

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Mortality from Aspiration Pneumonia: Incidence, Trends, and Risk Factors

Cited by 46 publications

References 15 publications

Aspiration pneumonia

Aspiration pneumonia

Cost‐effectiveness of professional and mechanical oral care for preventing pneumonia in nursing home residents

Non-Invasive Sensor-Based Estimation of Anterior-Posterior Upper Esophageal Sphincter Opening Maximal Distension

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