Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2024

Open Access 01-12-2024 | Aspiration Pneumonia | Research

Incidence and characteristics of aspiration pneumonia in the Nagasaki Prefecture from 2005 to 2019

Authors: Iku Tomonaga, Hironobu Koseki, Chieko Imai, Takayuki Shida, Yuta Nishiyama, Daisuke Yoshida, Seiichi Yokoo, Makoto Osaki

Published in: BMC Pulmonary Medicine | Issue 1/2024

Login to get access

Abstract

Background

Aspiration pneumoniae remains a major health concern, particularly in the older population and has poor prognosis; however, the concept itself remains vague worldwide. This study aimed to determine the actual situation and characteristics of aspiration pneumonia from 2005 to 2019 in Nagasaki Prefecture, Japan.

Methods

Cases of aspiration pneumonia that occurred in the Nagasaki Prefecture between 2005 and 2019 were analyzed using emergency transportation records. The number of occurrences and incidence were analyzed according to age, sex, month, day of the week, and recognition time to clarify the actual situation of aspiration pneumonia.

Results

The total number of new aspiration pneumonia cases was 8,321, and the mean age of the patients was 83.0 years. Annual incidence per 100,000 population increased from 12.4 in 2005 to 65.1 in 2019, with the most prominent increase in the ≥ 80-year-old stratum. Males (55.1%) were more commonly affected than females (44.9%), and 82.2% of the cases involved patients aged ≥ 70 years. No significant correlations were observed between the incidence of aspiration pneumonia and season, month, or day of the week. Aspiration pneumonia occurred frequently in houses (39.8%) and facilities for elderly individuals (40.8%). At 7 days after admission, 80.9% of patients were still hospitalized and 6.5% had died.

Conclusions

The incidence of aspiration pneumonia with risks of severity and mortality is increasing among elderly individuals. Valid preventive measures are urgently needed based on the findings that the disease occurs in both household and elderly care facility settings, regardless of the season.
Appendix
Available only for authorised users
Literature
1.
go back to reference Van Der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JM, de Baat C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res. 2011;90:1398–404.CrossRefPubMed Van Der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JM, de Baat C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res. 2011;90:1398–404.CrossRefPubMed
2.
go back to reference Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T, et al. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56:577–9.CrossRefPubMed Teramoto S, Fukuchi Y, Sasaki H, Sato K, Sekizawa K, Matsuse T, et al. High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan. J Am Geriatr Soc. 2008;56:577–9.CrossRefPubMed
3.
go back to reference Hayashi M, Iwasaki T, Yamazaki Y, Takayasu H, Tateno H, Tazawa S, et al. Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia: a retrospective cohort study. J Infect Chemother. 2014;20:436–42.CrossRefPubMed Hayashi M, Iwasaki T, Yamazaki Y, Takayasu H, Tateno H, Tazawa S, et al. Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia: a retrospective cohort study. J Infect Chemother. 2014;20:436–42.CrossRefPubMed
4.
go back to reference Chong CP, Street PR. Pneumonia in the Elderly: A review of severity assessment, prognosis, mortality, prevention, and treatment. South Med J. 2008;101:1134–40.CrossRefPubMed Chong CP, Street PR. Pneumonia in the Elderly: A review of severity assessment, prognosis, mortality, prevention, and treatment. South Med J. 2008;101:1134–40.CrossRefPubMed
5.
go back to reference Taylor JK, Fleming GB, Singanayagam A, Hill AT, Chalmers JD. Risk factors for aspiration in community-acquired pneumonia: analysis of a hospitalized UK cohort. Am J Med. 2013;126:995–1001.CrossRefPubMed Taylor JK, Fleming GB, Singanayagam A, Hill AT, Chalmers JD. Risk factors for aspiration in community-acquired pneumonia: analysis of a hospitalized UK cohort. Am J Med. 2013;126:995–1001.CrossRefPubMed
6.
go back to reference Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41:923–8.CrossRefPubMed Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41:923–8.CrossRefPubMed
7.
go back to reference Cabré M, Serra-Prat M, Force L, Almirall J, Palomera E, Clavé P. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: observational prospective study. J Gerontol A Biol Sci Med Sci. 2014;69:330–7.CrossRefPubMed Cabré M, Serra-Prat M, Force L, Almirall J, Palomera E, Clavé P. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: observational prospective study. J Gerontol A Biol Sci Med Sci. 2014;69:330–7.CrossRefPubMed
9.
go back to reference Komiya K, Rubin BK, Kadota JI, Mukae H, Akaba T, Moro H, et al. Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis. Sci Rep. 2016;6:38097.CrossRefPubMedPubMedCentral Komiya K, Rubin BK, Kadota JI, Mukae H, Akaba T, Moro H, et al. Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis. Sci Rep. 2016;6:38097.CrossRefPubMedPubMedCentral
10.
go back to reference Fukuyama H, Yamashiro S, Tamaki H, Kishaba T. A prospective comparison of nursing- and healthcare-associated pneumonia (NHCAP) with community-acquired pneumonia (CAP). J Infect Chemotherapy. 2013;19:719–26.CrossRef Fukuyama H, Yamashiro S, Tamaki H, Kishaba T. A prospective comparison of nursing- and healthcare-associated pneumonia (NHCAP) with community-acquired pneumonia (CAP). J Infect Chemotherapy. 2013;19:719–26.CrossRef
11.
go back to reference Committee for the JRS Guidelines in Management of Pneumonia in Adults. The JRS guidelines for the management of pneumonia in adults. Tokyo: The Japanese Respiratory Society; 2017. (Article in Japanese). Committee for the JRS Guidelines in Management of Pneumonia in Adults. The JRS guidelines for the management of pneumonia in adults. Tokyo: The Japanese Respiratory Society; 2017. (Article in Japanese).
12.
go back to reference Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections–full version. Clin Microbiol Infect. 2011;17:E1-59.CrossRefPubMedPubMedCentral Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections–full version. Clin Microbiol Infect. 2011;17:E1-59.CrossRefPubMedPubMedCentral
14.
go back to reference Takahashi Y, Sato S, Yamashita K, Matsumoto N, Nozaki Y, Hirao T, et al. Effects of a trauma center on early mortality after trauma in a regional city in Japan: a population-based study. Trauma Surg Acute Care Open. 2019;4: e000291.CrossRefPubMedPubMedCentral Takahashi Y, Sato S, Yamashita K, Matsumoto N, Nozaki Y, Hirao T, et al. Effects of a trauma center on early mortality after trauma in a regional city in Japan: a population-based study. Trauma Surg Acute Care Open. 2019;4: e000291.CrossRefPubMedPubMedCentral
15.
go back to reference Koseki H, Sunagawa S, Noguchi C, Yonekura A, Matsumura U, Watanabe K, et al. Incidence of and risk factors for hip fracture in Nagasaki, Japan from 2005 to 2014. Arch Osteoporos. 2021;16:1–8.CrossRef Koseki H, Sunagawa S, Noguchi C, Yonekura A, Matsumura U, Watanabe K, et al. Incidence of and risk factors for hip fracture in Nagasaki, Japan from 2005 to 2014. Arch Osteoporos. 2021;16:1–8.CrossRef
17.
go back to reference Terpenning MS, Taylor GW, Lopatin DE, Kerr CK, Dominguez BL, Loesche WJ. Aspiration pneumonia: dental and oral risk factors in an older veteran population. J Am Geriatr Soc. 2001;49:557–63.CrossRefPubMed Terpenning MS, Taylor GW, Lopatin DE, Kerr CK, Dominguez BL, Loesche WJ. Aspiration pneumonia: dental and oral risk factors in an older veteran population. J Am Geriatr Soc. 2001;49:557–63.CrossRefPubMed
18.
go back to reference Yamanda S, Ebihara S, Ebihara T, Yamasaki M, Arai H, Kohzuki M. Bacteriology of aspiration pneumonia due to delayed triggering of the swallowing reflex in elderly patients. J Hosp Infect. 2010;74:399–401.CrossRefPubMed Yamanda S, Ebihara S, Ebihara T, Yamasaki M, Arai H, Kohzuki M. Bacteriology of aspiration pneumonia due to delayed triggering of the swallowing reflex in elderly patients. J Hosp Infect. 2010;74:399–401.CrossRefPubMed
19.
go back to reference Akata K, Yatera K, Yamasaki K, Kawanami T, Naito K, Noguchi S, et al. The significance of oral streptococci in patients with pneumonia with risk factors for aspiration: the bacterial floral analysis of 16S ribosomal RNA gene using bronchoalveolar lavage fluid. BMC Pulm Med. 2016;16:79.CrossRefPubMedPubMedCentral Akata K, Yatera K, Yamasaki K, Kawanami T, Naito K, Noguchi S, et al. The significance of oral streptococci in patients with pneumonia with risk factors for aspiration: the bacterial floral analysis of 16S ribosomal RNA gene using bronchoalveolar lavage fluid. BMC Pulm Med. 2016;16:79.CrossRefPubMedPubMedCentral
20.
21.
go back to reference Huxley EJ, Viroslav J, Gray WR, Pierce AK. Pharyngeal aspiration in normal adults and patients with depressed consciousness. Am J Med. 1978;64:564–8.CrossRefPubMed Huxley EJ, Viroslav J, Gray WR, Pierce AK. Pharyngeal aspiration in normal adults and patients with depressed consciousness. Am J Med. 1978;64:564–8.CrossRefPubMed
22.
go back to reference Gleeson K, Eggli DF, Maxwell SL. Quantitative aspiration during sleep in normal subjects. Chest. 1997;111:1266–72.CrossRefPubMed Gleeson K, Eggli DF, Maxwell SL. Quantitative aspiration during sleep in normal subjects. Chest. 1997;111:1266–72.CrossRefPubMed
23.
go back to reference Pinto A, Yanai M, Nakagawa T, Sekizawa K, Sasaki H. Swallowing reflex in the night. Lancet. 1994;344:820–1.CrossRefPubMed Pinto A, Yanai M, Nakagawa T, Sekizawa K, Sasaki H. Swallowing reflex in the night. Lancet. 1994;344:820–1.CrossRefPubMed
24.
go back to reference Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA, et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech Lang Hear Res. 2008;51:173–83.CrossRefPubMed Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA, et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech Lang Hear Res. 2008;51:173–83.CrossRefPubMed
Metadata
Title
Incidence and characteristics of aspiration pneumonia in the Nagasaki Prefecture from 2005 to 2019
Authors
Iku Tomonaga
Hironobu Koseki
Chieko Imai
Takayuki Shida
Yuta Nishiyama
Daisuke Yoshida
Seiichi Yokoo
Makoto Osaki
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-024-03015-8

Other articles of this Issue 1/2024

BMC Pulmonary Medicine 1/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.