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J Hosp Med. 2013 Feb;8(2):83-90. doi: 10.1002/jhm.1996. Epub 2012 Nov 26.

Mortality, morbidity, and disease severity of patients with aspiration pneumonia.

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Division of Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.



Aspiration pneumonia is a common syndrome, although less well characterized than other pneumonia syndromes. We describe a large population of patients with aspiration pneumonia.


In this retrospective population study, we queried the electronic medical records at a tertiary-care, university-affiliated hospital from 1996 to 2006. Patients were initially identified by International Classification of Diseases, 9th Revision code 507.x; subsequent physician chart review excluded patients with aspiration pneumonitis and those without a confirmatory radiograph. Patients with community-acquired aspiration pneumonia were compared to a contemporaneous population of community-acquired pneumonia (CAP) patients. We compared CURB-65 (a clinical prediction rule based on Confusion, Uremia, Respiratory rate, Blood Pressure, and age)-predicted mortality with actual 30-day mortality.


We identified 628 patients with aspiration pneumonia, of which 510 were community-acquired. Median age was 77 years, with 30-day mortality of 21%. Compared to CAP patients, patients with community-acquired aspiration pneumonia had more frequent inpatient admission (99% vs 58%) and intensive care unit admission (38% vs 14%), higher Charlson comorbidity index (3 vs 1), and higher prevalence of do not resuscitate/intubate orders (24% vs 11%). CURB-65 predicted mortality poorly in aspiration pneumonia patients (area under the curve, 0.66).


Patients with community-acquired aspiration pneumonia are older, have more comorbidities, and demonstrate higher mortality than CAP patients, even after adjustment for age and comorbidities. CURB-65 poorly predicts mortality in this population.

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