Palacios-Ceña Domingo, Hernández-Barrera Valentín, López-de-Andrés Ana, Fernández-de-Las-Peñas César, Palacios-Ceña María, de Miguel-Díez Javier, Carrasco-Garrido Pilar, Jiménez-García Rodrigo
Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Medicine and Surgery, Psychology, Preventive Medicine and Public Health, Medical Microbiology and Immunology and Nursing Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Eur J Intern Med. 2017 Mar;38:61-67. doi: 10.1016/j.ejim.2016.12.022. Epub 2017 Jan 5.
Aspiration pneumonia (AP) is an infectious process causing high rates of mortality. The purpose of this study was: 1, to describe the incidence from 2003 to 2013 of AP hospitalizations; 2, to assess time trends in hospital outcomes variables, and; 3, to identify the factors independently associated with in-hospital mortality (IHM).
A retrospective observational study using the Spanish National Hospital Database, with patients discharged between January 2003 and December 2013 was conducted. Inclusion criteria were: Subjects aged 75years or older whose medical diagnosis included AP events code according to the ICD-9-CM: 507.x in the primary diagnosis field. Patient variables, up to 14 discharge diagnoses per patient, and up to 20 procedures performed during the hospital stay (ICD-9-CM), Charlson Comorbidity Index, readmission, length of hospital stay (LOHS), and IHM were analyzed.
We included 111,319 admissions (53.13% women). LOHS decreased in both sexes (P<0.001) and was significantly higher in men (10.4±10.31 vs. 9.56±10.02days). Readmissions increased significantly in women during the study (13.94% in 2003 to 16.41% in 2013, P<0.001). In both sex, IHM was significantly higher in >94years old subjects (OR: 1.43, 95%CI 1.36-1.51) and in those with readmissions (OR: 1.20, 95%CI 1.15-1.23). For the entire population, time trend analyses showed a significant decrease in mortality from 2003 to 2013 (OR: 0.96, 95%CI 0.95-0.97).
Patients with AP are older, male, and have more comorbidities than those without AP. Over time, LOHS and IHM decreased in both sexes, but readmissions increased significantly in women.
吸入性肺炎（AP）是一种导致高死亡率的感染性疾病。本研究的目的是：1. 描述2003年至2013年AP住院的发病率；2. 评估医院结局变量的时间趋势；3. 确定与院内死亡率（IHM）独立相关的因素。
使用西班牙国家医院数据库进行一项回顾性观察研究，纳入2003年1月至2013年12月期间出院的患者。纳入标准为：年龄在75岁及以上，其医学诊断包括根据ICD-9-CM在主要诊断字段中的AP事件代码：507.x。分析患者变量，每位患者最多14个出院诊断，以及住院期间最多20项操作（ICD-9-CM）、Charlson合并症指数、再入院情况、住院时间（LOHS）和IHM。
我们纳入了111319例入院患者（53.13%为女性）。两性的住院时间均有所下降（P<0.001），男性的住院时间显著更长（10.4±10.31天对9.56±10.02天）。在研究期间，女性的再入院率显著增加（从2003年的13.94%增至2013年的16.41%，P<0.001）。在两性中，94岁以上患者的IHM显著更高（OR：1.43，95%CI 1.36-1.51），再入院患者的IHM也显著更高（OR：1.20，95%CI 1.15-1.23）。对于整个人口，时间趋势分析显示2003年至2013年死亡率显著下降（OR：0.96，95%CI 0.95-0.97）。
与无AP的患者相比，AP患者年龄更大、为男性且合并症更多。随着时间的推移，两性的住院时间和IHM均有所下降，但女性的再入院率显著增加。
