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

Published:January 05, 2017DOI:https://doi.org/10.1016/j.ejim.2016.12.022

      Highlights

      • Aspiration pneumonia is an infectious process causing high rates of mortality.
      • Older people had longer hospital stay, readmissions, and in-hospital mortality.
      • An observational study with older patients between 2003 and 2013 was conducted.
      • Length of hospital stay and in-hospital mortality decreased in both sexes.
      • Readmissions increased significantly in women.

      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 75 years 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 ± 10.02 days). 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 >94 years 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

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