Incidence and Predictors of Aspiration Pneumonia among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow up Study (original) (raw)
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Aspiration pneumonia in patients with stroke, northeast nigeria
NATIONAL JOURNAL OF NEUROLOGY, 2019
Objectives: Aspiration pneumonia is a common complication in patients with stroke, having a negative influence on morbidity and mortality. This study sought to assess the frequency of aspiration pneumonia and the independent predictors for its development among Nigerian patients with stroke. Methods: Five hundred and twenty-four stroke patients were prospectively enrolled during the study period at the University of Maiduguri Teaching Hospital, Maiduguri, from January 2005 and May 2011. All patients who developed aspiration pneumonia during hospital stay and follow–up were recorded. A student’s t-test and a Pearson chi-square analysis was used to compare baseline characteristics of subjects who developed aspiration pneumonia and those who did not. A multiple logistic regression was used to assess the independent predictors of aspiration pneumonia. We also recorded the rate of deaths and duration hospital stay within this period. Results: Aspiration pneumonia occurred in 65 (12.4%) ...
Prevalence of aspiration Pneumonia in Stroke Patients at Tertiary Care Hospital
Background: One of the major health problems after stroke is aspiration pneumonia which might cause death. Aspiration pneumonia occurs in patients both with ischemic stroke and hemorrhagic stroke. Objective: To assess the prevalence of aspiration Pneumonia in stroke patients Methodology: This descriptive and cross-sectional study was carried out at the Medicine department, Qazi Hussain Ahmad Medical Complex, Nowshera from July 2020 to July 2021. By using pre-designed Performa, all the data including stroke type, name, age and gender of the patient and diagnosis of aspiration pneumonia were documented. All the analysis of the recorded data was carried out by employing SPSS version 24. Results: In the current study, totally 180 patients were enrolled. There were 102 (56.67%) males participants while female participants were 78 (43.33%). On the basis of age distribution, 69 (38.335%) patients were observed in age group 40-60 years whereas 111 (61.67%) patients were observed in age group 61-80 years. The mean age (SD) in the current study was 61 (3.11) years. Based on type of stroke, 117 (65%) patients were observed with ischemic stroke whereas 63 (35%) patients were observed with hemorrhagic stroke. The overall frequency of aspiration pneumonia in stroke patients was 15.56% (n=28). Practical implication: Our study will provide physicians with new data that early diagnosis for aspiration pneumonia in stroke patients should be done to reduce the morbidity and mortality rates. Conclusion: Aspiration pneumonia is highly prevalent in stroke patients in our setting. Our study recommends that early diagnosis for aspiration pneumonia in stroke patients should be done to reduce the morbidity and mortality rates.
Frequency of Aspiration Pneumonia in Patients with Stroke
Pakistan Journal of Medical and Health Sciences, 2022
Background: Among persons over sixty, stroke is the 2nd major cause of death, and the sixth greatest cause of death among those aged 15 to 59 years. It is also one of the most common causes of disability and death. Respiratory complications are very common in stroke patients. Pneumonia affects up to a third of those who have had a stroke. Objective: To find out frequency of aspiration pneumonia in stroke patients Methodology: This study design was Descriptive cross-sectional conducted at the Medicine department, Khyber Teaching Hospital, Peshawar from 15Th October 2019 to 15th April 2020. All patients admitted in medical D unit meeting the inclusion criteria were included in the study. Necessary investigations such as sputum examination, chest x-ray, total leukocyte count and physical examination was done to confirm aspiration pneumonia. Data analysis was done by using IBM SPSS version 23. Results: Ischemic stroke amongst 100 patients was observed in 68(68%) patients while hemorrhag...
Infezioni in medicina, 2018
Aspiration pneumonia has a high incidence in hospitalized patients with community-acquired pneumonia and results in high mortality rates. We aimed to evaluate microbiology and assess prognostic factors of aspiration pneumonia in the setting of a tertiary hospital pulmonology department. Community-acquired (CAAP) and healthcare-associated aspiration pneumonia (HCAAP) cases hospitalized over a period of a year were prospectively followed. Demographic, clinical, biological and radiological data were recorded at admission, while sputum, tracheal aspirates or bronchial washing samples were collected within 48 hours of admission. During hospital stay, therapeutic and supportive measures and resulting complications were recorded. Regression analysis was applied to find statistically significant prognostic factors. The sample consisted of 70 patients (67.1% men); 55.7% of them presented as HCAAP. 94.3% had positive culture of lower respiratory tract specimens with isolation of 115 pathogens, 47 of which were multidrug- or extensively drug-resistant. The most common pathogens were Pseudomonas aeruginosa (37.1%), Klebsiella pneumoniae (27.1%), Staphylococcus aureus (25.7%) and Acinetobacter baumannii (20%). Empiric antimicrobial therapy was combination therapy in 70% and included antipseudomonal and MRSA-targeted antibiotics in 61.4% and 11.4%, respectively. Patients in the HCAAP group had a higher rate of antibiotics usage in the previous trimester, more frequent isolation of resistant strains and were more likely to receive inadequate empiric treatment than those in the CAAP group. In-hospital mortality was 52.2%; no difference between groups was noted. Independent factors of increased mortality were older age (p=0.004), low serum albumin levels (p=0.039), increased radiological involvement (p=0.050) and ineffective initial therapy (p=0.001). We concluded that patients hospitalized for aspiration pneumonia have frequent contact with healthcare services and acquire multidrug-resistant Gram-negative bacteria. Empiric therapy should target these specific microorganisms as its success determines the prognosis.
Journal of the American Geriatrics Society, 2000
OBJECTIVES: To determine the prevalence of aspiration pneumonia and to compare the features and risk factors for this entity in patients from continuing care facilities (CCFs) and the community who were admitted to the hospital with pneumonia. DESIGN: Prospective population-based study. SETTING: Six hospitals in Capital Health Region (Edmonton), Alberta, Canada. PARTICIPANTS: One thousand nine hundred forty-six adults admitted with pneumonia. Patients were stratified by their residence as community or CCF. MEASUREMENTS: Aspiration pneumonia prevalence; risk factors; and outcomes such as mortality, length of stay, and intensive care unit admission rates. RESULTS: Ten percent of those with community-acquired pneumonia (CAP) had aspirated, compared with 30% of those with CCF-acquired pneumonia. Those with community-acquired aspiration pneumonia (CAAP) and those with CCF-acquired aspiration pneumonia (CCF-AP) were younger, more likely to go to ICU, and more likely to require mechanical ventilation and had a longer length of stay and a higher mortality rate than nonaspirators. The risk factors for aspiration differed; for those with CAAP, impaired consciousness due to alcohol, drugs, or hepatic failure predominated, whereas 72% of those with CCF-AP had neurological disease that resulted in dysphagia. Eighty percent were treated with antibiotics effective against anaerobic bacteria. CONCLUSION: Aspiration pneumonia is common in patients with both CAP and CCF-acquired pneumonia. The risk factors differ, and there is a high mortality rate. Neurological disease dominates as the predisposing factor toward aspiration pneumonia in people in CCFs.
Chest, 2021
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Program to Diagnose Probability of Aspiration Pneumonia in Patients with Ischemic Stroke
International Archives of Otorhinolaryngology, 2014
Introduction Stroke is a major cause of death and disability worldwide, with a strong economic and social impact. Approximately 40% of patients show motor, language, and swallowing disorders after stroke. Objective To evaluate the use of software to infer the probability of pneumonia in patients with ischemic stroke. Methods Prospective and cross-sectional study conducted in a university hospital from March 2010 to August 2012. After confirmation of ischemic stroke by computed axial tomography, a clinical and flexible endoscopic evaluation of swallowing was performed within 72 hours of onset of symptoms. All patients received speech therapy poststroke, and the data were subsequently analyzed by the software. The patients were given medical treatment and speech therapy for 3 months. Results The study examined 52 patients with a mean age of 62.05 AE 13.88 years, with 23 (44.2%) women. Of the 52 patients, only 3 (5.7%) had a probability of pneumonia between 80 and 100% as identified by the software. Of all patients, 32 (61.7%) had pneumonia probability between 0 and 19%, 5 (9.5%) between 20 and 49%, 3 (5.8%) between 50 and 79%, and 12 (23.0%) between 80 and 100%. Conclusion The computer program indicates the probability of patient having aspiration pneumonia after ischemic stroke.
A spiration pneumonia is best considered not as a distinct entity but as part of a continuum that also includes community-and hospital-acquired pneumonias. It is estimated that aspiration pneumonia accounts for 5 to 15% of cases of community-acquired pneumonia, but figures for hospital-acquired pneumonia are unavailable. 1 Robust diagnostic criteria for aspiration pneumonia are lacking, and as a result, studies of this disorder include heterogeneous patient populations. Aspiration of small amounts of oropharyngeal secretions is normal in healthy persons during sleep, yet microaspiration is also the major pathogenetic mechanism of most pneumonias. 2 Large-volume aspiration (macroaspiration) of colonized oropharyngeal or upper gastrointestinal contents is the sine qua non of aspiration pneumonia. Variables affecting patient presentation and disease management include bacterial virulence, the risk of repeated events, and the site of acquisition (nursing home, hospital, or community). According to this spectrum, patients labeled as having aspiration pneumonia usually represent a clinical phenotype with risk factors for macroaspiration and involvement of characteristic anatomical pulmonary locations. Aspiration syndromes may involve the airways or pulmonary parenchyma, resulting in a variety of clinical presentations. 3 This review focuses on aspiration involving the lung parenchyma, primarily aspiration pneumonia and chemical pneumonitis. Aspiration of noninfectious material such as blood or a foreign body is also important. Aspiration pneumonia is an infection caused by specific microorganisms, whereas chemical pneumonitis is an inflammatory reaction to irritative gastric contents. Our understanding of the interaction between bacteria and the lung has improved. We examine this improvement, along with changing concepts of the microbiology and pathogenesis of aspiration pneumonia. We also examine the clinical features, diagnosis, treatment , and prevention of both aspiration pneumonia and chemical pneumonitis, as well as the risk factors. Ch a nging Microbiol ogic a nd Pathogene tic Concep t s of A spir ation Pneumoni a Our understanding of normal lower-airway microbiota in humans has evolved with the use of targeted polymerase-chain-reaction studies, sequencing of bacterial 16S ribosomal RNA genes, and metagenomics. A recent study of oral microbiota in patients with acute stroke identified 103 different bacterial phylotypes, 29 of which had not been reported previously. 4 Whether these new microbes are pathogens is uncertain. The Human Microbiome Project has helped define the role that intestinal microorganisms play in the development of mucosal immunity and in the interplay between health and disease. Studies of the lung microbiome have challenged our