Characteristics and outcomes of patients hospitalized following pulmonary aspiration

Augustine Lee, Emir Festic, Pauline K. Park, Krishnan Raghavendran, Ousama Dabbagh, Adebola Adesanya, Ognjen Gajic, Raquel R. Bartz

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

BACKGROUND: Pulmonary aspiration is an important recognized cause of ARDS. Better characterization of patients who aspirate may allow identification of potential risks for aspiration that could be used in future studies to mitigate the occurrence of aspiration and its devastating complications.

METHODS: We conducted a secondary analysis of the Lung Injury Prediction Score cohort to better characterize patients with aspiration, including their potential risk factors and related outcomes.

RESULTS: Of the 5,584 subjects at risk for ARDS and who required hospitalization, 212 (3.8%) presented with aspiration. Subjects who aspirated were likely to be male (66% vs 56%, P < .007), slightly older (59 years vs 57 years), white (73% vs 61%, P 5 .0004), admitted from a nursing home (15% vs 5.9%, P < .0001), have a history of alcohol abuse (21% vs 8%, P < .0001), and have lower Glasgow Coma Scale (median, 13 vs 15; P < .0001). Aspiration subjects were sicker (higher APACHE [Acute Physiology and Chronic HealThevaluation] II score), required more mechanical ventilation (54% vs 32%, P < .0001), developed more moderate to severe ARDS (12% vs 3.8%, P < .0001), and were twofold more likely to die in-hospital, even aft er adjustment for severity of illness (OR 5 2.1; 95% CI, 1.2-3.6). Neither obesity nor gastroesophageal reflux was associated with aspiration.

CONCLUSIONS: Aspiration was more common in men with alcohol abuse history and a lower Glasgow Coma Scale who were admitted from a nursing home. It is independently associated with a significant increase in the risk for ARDS as well as morbidity and mortality. Findings from this study may facilitate the design of future clinical studies of aspiration-induced lung injury.

Original languageEnglish (US)
Pages (from-to)899-907
Number of pages9
JournalChest
Volume146
Issue number4
DOIs
StatePublished - Oct 1 2014

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, A., Festic, E., Park, P. K., Raghavendran, K., Dabbagh, O., Adesanya, A., Gajic, O., & Bartz, R. R. (2014). Characteristics and outcomes of patients hospitalized following pulmonary aspiration. Chest, 146(4), 899-907. https://doi.org/10.1378/chest.13-3028