February 03, 2016
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Complication rates greater among patients with aspiration pneumonia

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Patients with aspiration pneumonia had more complications, greater length of stay and 30-day readmission rates and higher hospital costs compared with patients who had nonaspiration pneumonia, according to recent research.

“In children with [neurologic impairment (NI)], pneumonia is one of the most common reasons for hospitalization, admission to an ICU, and death,” Joanna Thomson, MD, MPH, from the division of hospital medicine, Cincinnati Children’s Hospital Medical Center, and colleagues wrote. “In our clinical experience, pneumonia in children with NI, compared with otherwise healthy children, can be challenging to diagnose and treat because no validated clinical practice guidelines exist for pneumonia in children with NI.”

Thomson and colleagues retrospectively identified 27,455 patients with NI aged 1 to 18 years who were diagnosed with pneumonia from 2007 to 2012 across 40 children’s hospitals. The researchers recorded whether the patients had aspiration (9.7%) or nonaspiration pneumonia and examined the records for outcomes such as length of stay, 30-day readmission and acute respiratory failure.

They found that 34% of patients with aspiration pneumonia had complications vs. 15.2% of those who had nonaspiration pneumonia (adjusted OR = 1.2; 95% CI, 1.1-1.3). Patients with aspiration pneumonia stayed in the hospital a median of 5 days compared with 3 days in patients with nonaspiration pneumonia (ratio of means = 1.2; 95% CI, 1.2-1.3).

In addition, patients with aspiration pneumonia also had more transfers in the ICU (4.3% vs. 1.5%; aOR = 1.4; 95% CI, 1.1-1.9, more 30-day readmissions (17.4% vs. 6.8%; aOR = 1.3; 95% CI, 1.2-1.5) and increased median hospital costs ($11,594 vs. $5,162; ratio of means = 1.2; 95% CI, 1.2-1.3), according to the study.

“These findings highlight the serious health consequences of pneumonia that occur in children with NI,” Thomson and colleagues wrote. “It is important that these consequences are discussed with families of children with NI, especially the high rates of complications (34%) and 30-day hospital readmission (18%) in children diagnosed with aspiration pneumonia.

“Yet there remains a need to understand how to accurately distinguish pneumonia type; which antibiotics are most effective; and how bronchodilators, steroids, and other respiratory treatments can be leveraged to maximize pulmonary function.” – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.