Characteristics and outcomes of patients hospitalized following pulmonary aspiration.

Link to article at PubMed

Characteristics and outcomes of patients hospitalized following pulmonary aspiration.

Chest. 2014 May 8;

Authors: Lee A, Festic E, Park PK, Raghavendran K, Dabbagh O, Adesanya A, Gajic O, Bartz RR, and the United States Critical Illness and Injury Trials Group

ABSTRACT BACKGROUND: Pulmonary aspiration is an important recognized cause of acute respiratory distress syndrome (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 (LIPS) cohort to better characterize patients with aspiration, including their potential risk factors and related outcomes.
RESULTS: Of the 5584 subjects at risk for ARDS and required hospitalization, 212 (3.8%) presented with aspiration. Subjects who aspirated were likely to be male (66% vs. 56%, p<0.007), slightly older (59 vs. 57years), Caucasian (73% vs. 61%, p=0.0004), admitted from a nursing-home (15% vs. 5.9%, p<0.0001), have a history of alcohol abuse (21% vs. 8%, p<0.0001) and have lower Glasgow Coma Scale (median 13 vs. 15, p<0.0001). Aspiration subjects were sicker (higher APACHE2), required more mechanical ventilation (54% vs. 32%, p<0.0001), developed more moderate-to-severe ARDS (12% vs. 3.8%, p<0.0001), and were two-fold more likely to die in-hospital, even after adjustment for severity of illness (OR=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, a lower GCS, and when 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.

PMID: 24811480 [PubMed - as supplied by publisher]

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