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      In-hospital Outcomes of Aspiration Pneumonia Hospitalizations With Acute Heart Failure: A Nationwide Analysis

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      https://www.riss.kr/link?id=A109103020

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      다국어 초록 (Multilingual Abstract)

      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP).


      Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP with AHF vs. without AHF using relevant International Classification of Diseases, Tenth Revision codes. We compared the demographics, comorbidities, and outcomes between the two groups.


      Results Out of the 121,097,410 weighted adult hospitalizations, 488,260 had AP, of which 13.25% (n=64,675) had AHF. The AHF cohort consisted predominantly of the elderly (mean age 80.4 vs. 71.1 years), females (47.8% vs. 42.2%), and whites (81.6% vs. 78.5%) than non-AHF cohort (all p<0.001). Complicated diabetes and hypertension, dyslipidemia, obesity, chronic pulmonary disease, and prior myocardial infarction were more frequent in AHF than in the non-AHF cohort. AP-AHF cohort had similar adjusted odds of all-cause mortality (adjusted odds ratio [AOR], 0.9; 95% confidence interval [CI], 0.78–1.03; p=0.122), acute respiratory failure (AOR, 1.0; 95% CI, 0.96–1.13; p=0.379), but higher adjusted odds of cardiogenic shock (AOR, 2.2; 95% CI, 1.30–3.64; p=0.003), and use of mechanical ventilation (MV) (AOR, 1.3; 95% CI, 1.17–1.56; p<0.001) compared to AP only cohort. AP-AHF cohort more frequently required longer durations of MV and hospital stays with a higher mean cost of the stay.


      Conclusions Our study from a nationally representative database demonstrates an increased morbidity burden, worsened complications, and higher hospital resource utilization, although a similar risk of all-cause mortality in AP patients with AHF vs. no AHF.
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      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP). Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP wit...

      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP).


      Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP with AHF vs. without AHF using relevant International Classification of Diseases, Tenth Revision codes. We compared the demographics, comorbidities, and outcomes between the two groups.


      Results Out of the 121,097,410 weighted adult hospitalizations, 488,260 had AP, of which 13.25% (n=64,675) had AHF. The AHF cohort consisted predominantly of the elderly (mean age 80.4 vs. 71.1 years), females (47.8% vs. 42.2%), and whites (81.6% vs. 78.5%) than non-AHF cohort (all p<0.001). Complicated diabetes and hypertension, dyslipidemia, obesity, chronic pulmonary disease, and prior myocardial infarction were more frequent in AHF than in the non-AHF cohort. AP-AHF cohort had similar adjusted odds of all-cause mortality (adjusted odds ratio [AOR], 0.9; 95% confidence interval [CI], 0.78–1.03; p=0.122), acute respiratory failure (AOR, 1.0; 95% CI, 0.96–1.13; p=0.379), but higher adjusted odds of cardiogenic shock (AOR, 2.2; 95% CI, 1.30–3.64; p=0.003), and use of mechanical ventilation (MV) (AOR, 1.3; 95% CI, 1.17–1.56; p<0.001) compared to AP only cohort. AP-AHF cohort more frequently required longer durations of MV and hospital stays with a higher mean cost of the stay.


      Conclusions Our study from a nationally representative database demonstrates an increased morbidity burden, worsened complications, and higher hospital resource utilization, although a similar risk of all-cause mortality in AP patients with AHF vs. no AHF.

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      다국어 초록 (Multilingual Abstract)

      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP).




      Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP with AHF vs. without AHF using relevant International Classification of Diseases, Tenth Revision codes. We compared the demographics, comorbidities, and outcomes between the two groups.




      Results Out of the 121,097,410 weighted adult hospitalizations, 488,260 had AP, of which 13.25% (n=64,675) had AHF. The AHF cohort consisted predominantly of the elderly (mean age 80.4 vs. 71.1 years), females (47.8% vs. 42.2%), and whites (81.6% vs. 78.5%) than non-AHF cohort (all p<0.001). Complicated diabetes and hypertension, dyslipidemia, obesity, chronic pulmonary disease, and prior myocardial infarction were more frequent in AHF than in the non-AHF cohort. AP-AHF cohort had similar adjusted odds of all-cause mortality (adjusted odds ratio [AOR], 0.9; 95% confidence interval [CI], 0.78–1.03; p=0.122), acute respiratory failure (AOR, 1.0; 95% CI, 0.96–1.13; p=0.379), but higher adjusted odds of cardiogenic shock (AOR, 2.2; 95% CI, 1.30–3.64; p=0.003), and use of mechanical ventilation (MV) (AOR, 1.3; 95% CI, 1.17–1.56; p<0.001) compared to AP only cohort. AP-AHF cohort more frequently required longer durations of MV and hospital stays with a higher mean cost of the stay.




      Conclusions Our study from a nationally representative database demonstrates an increased morbidity burden, worsened complications, and higher hospital resource utilization, although a similar risk of all-cause mortality in AP patients with AHF vs. no AHF.
      번역하기

      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP). Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP w...

      Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP).




      Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP with AHF vs. without AHF using relevant International Classification of Diseases, Tenth Revision codes. We compared the demographics, comorbidities, and outcomes between the two groups.




      Results Out of the 121,097,410 weighted adult hospitalizations, 488,260 had AP, of which 13.25% (n=64,675) had AHF. The AHF cohort consisted predominantly of the elderly (mean age 80.4 vs. 71.1 years), females (47.8% vs. 42.2%), and whites (81.6% vs. 78.5%) than non-AHF cohort (all p<0.001). Complicated diabetes and hypertension, dyslipidemia, obesity, chronic pulmonary disease, and prior myocardial infarction were more frequent in AHF than in the non-AHF cohort. AP-AHF cohort had similar adjusted odds of all-cause mortality (adjusted odds ratio [AOR], 0.9; 95% confidence interval [CI], 0.78–1.03; p=0.122), acute respiratory failure (AOR, 1.0; 95% CI, 0.96–1.13; p=0.379), but higher adjusted odds of cardiogenic shock (AOR, 2.2; 95% CI, 1.30–3.64; p=0.003), and use of mechanical ventilation (MV) (AOR, 1.3; 95% CI, 1.17–1.56; p<0.001) compared to AP only cohort. AP-AHF cohort more frequently required longer durations of MV and hospital stays with a higher mean cost of the stay.




      Conclusions Our study from a nationally representative database demonstrates an increased morbidity burden, worsened complications, and higher hospital resource utilization, although a similar risk of all-cause mortality in AP patients with AHF vs. no AHF.

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      참고문헌 (Reference)

      1 Lindenauer PK, "Variation in the diagnosis of aspiration pneumonia and association with hospital pneumonia outcomes" 15 : 562-569, 2018

      2 Modi K, "Utilization of left ventricular assist device for congestive heart failure : inputs on demographic and hospital characterization from nationwide inpatient sample" 13 : e16094-, 2021

      3 Merx MW, "Sepsis and the heart" 116 : 793-802, 2007

      4 Won JH, "Risk and mortality of aspiration pneumonia in Parkinson’s disease : a nationwide database study" 11 : 6597-, 2021

      5 Pine MB, "Resistance of contracting myocardium to swelling with hypoxia and glycolytic blockade" 13 : 215-224, 1979

      6 Khadka S, "Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care : a systematic review" 50 : 81-87, 2021

      7 Drosatos K, "Pathophysiology of sepsis-related cardiac dysfunction : driven by inflammation, energy mismanagement, or both" 12 : 130-140, 2015

      8 Chen J, "National trends in heart failure hospital stay rates, 2001 to 2009" 61 : 1078-1088, 2013

      9 Wu CP, "National trends in admission for aspiration pneumonia in the United States, 2002–2012" 14 : 874-879, 2017

      10 Lanspa MJ, "Mortality, morbidity, and disease severity of patients with aspiration pneumonia" 8 : 83-90, 2013

      1 Lindenauer PK, "Variation in the diagnosis of aspiration pneumonia and association with hospital pneumonia outcomes" 15 : 562-569, 2018

      2 Modi K, "Utilization of left ventricular assist device for congestive heart failure : inputs on demographic and hospital characterization from nationwide inpatient sample" 13 : e16094-, 2021

      3 Merx MW, "Sepsis and the heart" 116 : 793-802, 2007

      4 Won JH, "Risk and mortality of aspiration pneumonia in Parkinson’s disease : a nationwide database study" 11 : 6597-, 2021

      5 Pine MB, "Resistance of contracting myocardium to swelling with hypoxia and glycolytic blockade" 13 : 215-224, 1979

      6 Khadka S, "Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care : a systematic review" 50 : 81-87, 2021

      7 Drosatos K, "Pathophysiology of sepsis-related cardiac dysfunction : driven by inflammation, energy mismanagement, or both" 12 : 130-140, 2015

      8 Chen J, "National trends in heart failure hospital stay rates, 2001 to 2009" 61 : 1078-1088, 2013

      9 Wu CP, "National trends in admission for aspiration pneumonia in the United States, 2002–2012" 14 : 874-879, 2017

      10 Lanspa MJ, "Mortality, morbidity, and disease severity of patients with aspiration pneumonia" 8 : 83-90, 2013

      11 Gupte T, "Mortality from aspiration pneumonia : incidence, trends, and risk factors" 37 : 1493-1500, 2022

      12 Yoon HY, "Long-term mortality and prognostic factors in aspiration pneumonia" 20 : 1098-1104, 2019

      13 Mankowski RT, "Long-term impact of sepsis on cardiovascular health" 45 : 78-81, 2019

      14 Reina-Couto M, "Inflammation in human heart failure : major mediators and therapeutic targets" 12 : 746494-, 2021

      15 Moore BJ, "Identifying increased risk of readmission and in-hospital mortality using hospital administrative data : the AHRQ Elixhauser Comorbidity Index" 55 : 698-705, 2017

      16 Arfaras-Melainis A, "Heart failure and sepsis : practical recommendations for the optimal management" 25 : 183-194, 2020

      17 Benjamin EJ, "Heart disease and stroke statistics-2017 update : a report from the American Heart Association" 135 : e146-e603, 2017

      18 Hainmueller J, "Entropy balancing for causal effects : a multivariate reweighting method to produce balanced samples in observational studies" 20 : 25-46, 2012

      19 Elixhauser A, "Comorbidity measures for use with administrative data" 36 : 8-27, 1998

      20 Chebl RB, "Clinical outcome of septic patients with heart failure with preserved ejection fraction presenting to the emergency department of a tertiary hospital: a retrospective cohort study" 7 : 517999-, 2020

      21 Hayashi M, "Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia : a retrospective cohort study" 20 : 436-442, 2014

      22 Lanspa MJ, "Characteristics associated with clinician diagnosis of aspiration pneumonia : a descriptive study of afflicted patients and their outcomes" 10 : 90-96, 2015

      23 Mandell LA, "Aspiration pneumonia" 380 : 651-663, 2019

      24 Tandon V, "An observation of racial and gender disparities in congestive heart failure admissions using the national inpatient sample" 12 : e10914-, 2020

      25 Christiansen MN, "Age-specific trends in incidence, mortality, and comorbidities of heart failure in Denmark, 1995 to 2012" 135 : 1214-1223, 2017

      26 Miller PE, "Acute decompensated heart failure complicated by respiratory failure" 12 : e006013-, 2019

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