Department of Pediatrics, Virginia Commonwealth University School of Medicine, 1217 East Marshall Street: KMSB, Room 215 Richmond, Virginia 23298, USA.
Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
Sci Rep. 2016 Dec 7;6:38097. doi: 10.1038/srep38097.
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.
社区获得性肺炎（CAP）患者发生吸入性肺炎与不良预后相关。然而，目前尚无系统评价评估 CAP 患者中吸入性肺炎对结局的影响。本研究采用 MOOSE 指南进行综述：患者：定义为 CAP 患者。
将有吸入风险的患者定义为吸入性肺炎。比较：未被认为存在口腔吸入高风险的患者中确诊的肺炎。
死亡率、住院再入院或复发性肺炎。三位研究者独立从 PubMed、CENTRAL 数据库和 EMBASE 中确定了已发表的队列研究。本系统评价纳入了 19 项研究。吸入性肺炎增加了住院死亡率（相对风险，3.62；95%置信区间，2.65-4.96；P<0.001，7 项研究）和 30 天死亡率（3.57；2.18-5.86；P<0.001，5 项研究）。相比之下，吸入性肺炎与 ICU 死亡率降低相关（相对风险，0.40；95%置信区间，0.26-0.60；P<0.00001，4 项研究）。尽管尚无足够的数据对长期死亡率、复发性肺炎和住院再入院进行荟萃分析，但少数报道的研究表明，吸入性肺炎也与这些不良结局相关。总之，在 ICU 外的 CAP 患者中，吸入性肺炎与住院和 30 天死亡率均升高相关。
