PURPOSE: Because of the increased aging population and out-of-hospital care, the number of hospitalizations for health care-associated pneumonia (HCAP) and aspiration pnweumonia is expected to increase in these days. However, the incidence of aspiration pneumonia in HCAP has not been examined.We examined the prevalence of HCAP in community-acquired pneumonia (CAP) patients in hospitalized patients. Further, the incidence and featgures of aspiration pneumonia in the CAP and HCAP were compared.
METHODS: Four hundred and thirty patients were recruited from 20 hospitals in the different area in Japan. HCAP was diagnosed followed as ATS/IDSA guidelines. The aspiration pneumonia (ASP) was diagnosed by the pulmonary experts. The pneumonia with a predisposition to aspirate due to dysphagia or swallowing disorders was diagnosed as ASP.
RESULTS: The approximately 34 % of the CAP patients could be diagnosed as HCAP. The incidence of aspiration pneumonia in CAP patients was 60%, whereas the incidence of aspiration pneumonia in newly re-diagnosed HCAP patients was greater than 90%.The HCAP patients were older, lower BMI, poor performance status than in CAP patients.
CONCLUSION: One thirds of CAP patients were diagnosed as HCAP. The incidence of aspiration pneumonia is very high in HCAP rather than in the CAP patients except HCAP.
CLINICAL IMPLICATIONS: Therapeutic approach for aspiration pneumonia may be important for the good prognosis of HCAP.
DISCLOSURE: Shinji Teramoto, No Financial Disclosure Information; No Product/Research Disclosure Information