Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis.

January 15, 2017 at 3:44 pm

Sci Rep. 2016 Dec 7;6:38097.

Komiya K1,2,3, Rubin BK1, Kadota JI2, Mukae H4, Akaba T1, Moro H5, Aoki N5, Tsukada H6, Noguchi S7, Shime N8, Takahashi O9, Kohno S4.

Author information

1Department of Pediatrics, Virginia Commonwealth University School of Medicine, 1217 East Marshall Street: KMSB, Room 215 Richmond, Virginia 23298, USA.

2Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.

3Clinical Research Center of Respiratory Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, 879-7761, Japan.

4Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

5Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahi-machi, Chuo-ku, Niigata, 951-8510, Japan.

6Department of Respiratory Medicine/Infectious Disease, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.

7Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Idaigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

8Department of Emergency and Critical Care Medicine, Institute of Biomedical &Health Sciences, Hiroshima University Advanced Emergency and Critical Care Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.

9Center for Clinical Epidemiology, St. Luke’s Life Science Institute, 10-1 Akashicho, Chuo-ku, Tokyo, 104-0044, Japan.


Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP.

This review was conducted using the MOOSE guidelines

Patients: patients defined CAP.


aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to be at high risk for oral aspiration.


mortality, hospital readmission or recurrent pneumonia. Three investigators independently identified published cohort studies from PubMed, CENTRAL database, and EMBASE. Nineteen studies were included for this systematic review. Aspiration pneumonia increased in-hospital mortality (relative risk, 3.62; 95% CI, 2.65-4.96; P < 0.001, seven studies) and 30-day mortality (3.57; 2.18-5.86; P < 0.001, five studies). In contrast, aspiration pneumonia was associated with decreased ICU mortality (relative risk, 0.40; 95% CI, 0.26-0.60; P < 0.00001, four studies). Although there are insufficient data to perform a meta-analysis on long-term mortality, recurrent pneumonia, and hospital readmission, the few reported studies suggest that aspiration pneumonia is also associated with these poor outcomes. In conclusion, aspiration pneumonia was associated with both higher in-hospital and 30-day mortality in patients with CAP outside ICU settings.



Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Infecciones respiratorias, Meta-Análisis, Metodos diagnosticos, REPORTS, Resistencia bacteriana, REVIEWS, Sepsis, Update.

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