Dr. Yuki Honda (graduate student) of Hamamatsu University School of Medicine and colleagues in collaboration with Seirei Hamamatsu Hospital have determined that the median survival time after discharge for elderly patients admitted to the hospital with aspiration pneumonia is approximately 1 year, and 5 years after discharge. The survival rate was 13%, indicating a poor prognosis.
Aspiration pneumonia is pneumonia caused by aspiration of food, drink, vomit, saliva, etc. (intrusion into the respiratory tract), and is common among elderly people. It is the 4th leading cause of death among Japanese people in 6 (3.6% of all deaths). There have been few reports on the long-term prognosis of patients with aspiration pneumonia, and in particular, there have been no studies on the survival period of patients who survive to hospital discharge. Therefore, we conducted a study on patients (age 65 and older, 269 patients) who were admitted to Seirei Hamamatsu Hospital with aspiration pneumonia, did not die during hospitalization, and were discharged alive.
As a result, the survival period starting from the day of discharge was approximately 1 year (median 369 days), and the survival rate 5 years after discharge was 13%. The survival period by means of nutritional intake at the time of discharge is approximately 1 year and 8 months (620 days) for oral intake and approximately 9 months (264 days) for tube feeding (nasogastric tube, gastrostomy, etc.) It took about a month (1 days) with intravenous drip. Since the average life expectancy for an 34-year-old during the same period was approximately six years for men and eight years for women, the prognosis for elderly patients hospitalized with aspiration pneumonia was found to be poor.
Furthermore, the risk of death was approximately 2.4 times higher for men than for women, and approximately 18.5 times higher for those with a BMI of less than 2 kg/m18.5 than for those with a BMI of 2 kg/m2.2 or higher. Regarding the method of nutritional intake at discharge, tube feeding had a 1.7 times higher risk of death than oral feeding, and IV feeding had a 4.4 times higher risk of death.
The results of this study showed that elderly patients admitted to an acute care hospital with aspiration pneumonia had a poor survival prognosis after discharge. It is hoped that the system will help patients and their families discuss and make decisions about how to spend their remaining time and what kind of medical care and nursing care they would like to receive.
Paper information:[Dysphagia] Extremely Poor Post-discharge Prognosis in Aspiration Pneumonia and Its Prognostic Factors: A Retrospective Cohort Study
