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Eur J Intern Med. 2017 Mar;38:61-67. doi: 10.1016/j.ejim.2016.12.022. Epub 2017 Jan 5.

Time trends in incidence and outcomes of hospitalizations for aspiration pneumonia among elderly people in Spain (2003-2013).

Author information

1
Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: domingo.palacios@urjc.es.
2
Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology and Nursing Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: valentin.hernandez@urjc.es.
3
Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology and Nursing Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: ana.lopez@urjc.es.
4
Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: cesar.fernandez@urjc.es.
5
Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: maria.palacios@urjc.es.
6
Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain. Electronic address: javier.miguel@salud.madrid.org.
7
Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology and Nursing Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: pilar.carrasco@urjc.es.
8
Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology and Nursing Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.

Abstract

BACKGROUND:

Aspiration pneumonia (AP) is an infectious process causing high rates of mortality. The purpose of this study was: 1, to describe the incidence from 2003 to 2013 of AP hospitalizations; 2, to assess time trends in hospital outcomes variables, and; 3, to identify the factors independently associated with in-hospital mortality (IHM).

METHODS:

A retrospective observational study using the Spanish National Hospital Database, with patients discharged between January 2003 and December 2013 was conducted. Inclusion criteria were: Subjects aged 75years or older whose medical diagnosis included AP events code according to the ICD-9-CM: 507.x in the primary diagnosis field. Patient variables, up to 14 discharge diagnoses per patient, and up to 20 procedures performed during the hospital stay (ICD-9-CM), Charlson Comorbidity Index, readmission, length of hospital stay (LOHS), and IHM were analyzed.

RESULTS:

We included 111,319 admissions (53.13% women). LOHS decreased in both sexes (P<0.001) and was significantly higher in men (10.4±10.31 vs. 9.56±10.02days). Readmissions increased significantly in women during the study (13.94% in 2003 to 16.41% in 2013, P<0.001). In both sex, IHM was significantly higher in >94years old subjects (OR: 1.43, 95%CI 1.36-1.51) and in those with readmissions (OR: 1.20, 95%CI 1.15-1.23). For the entire population, time trend analyses showed a significant decrease in mortality from 2003 to 2013 (OR: 0.96, 95%CI 0.95-0.97).

CONCLUSIONS:

Patients with AP are older, male, and have more comorbidities than those without AP. Over time, LOHS and IHM decreased in both sexes, but readmissions increased significantly in women.

KEYWORDS:

Aged; Aspiration; Epidemiology; Hospital mortality; Pneumonia; Pulmonary

PMID:
28065660
DOI:
10.1016/j.ejim.2016.12.022
[Indexed for MEDLINE]

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