title: Characteristics and outcomes of patients hospitalized following pulmonary aspiration.
abstract: BACKGROUND
  Pulmonary aspiration is an important recognized cause of ARDS. Better characterization of patients who aspirate may allow identification of potential risks for aspiration that could be used in future studies to mitigate the occurrence of aspiration and its devastating complications.
  
  
  METHODS
  We conducted a secondary analysis of the Lung Injury Prediction Score cohort to better characterize patients with aspiration, including their potential risk factors and related outcomes.
  
  
  RESULTS
  Of the 5,584 subjects at risk for ARDS and who required hospitalization, 212 (3.8%) presented with aspiration. Subjects who aspirated were likely to be male (66% vs 56%, P < .007), slightly older (59 years vs 57 years), white (73% vs 61%, P = .0004), admitted from a nursing home (15% vs 5.9%, P < .0001), have a history of alcohol abuse (21% vs 8%, P < .0001), and have lower Glasgow Coma Scale (median, 13 vs 15; P < .0001). Aspiration subjects were sicker (higher APACHE [Acute Physiology and Chronic Health Evaluation] II score), required more mechanical ventilation (54% vs 32%, P < .0001), developed more moderate to severe ARDS (12% vs 3.8%, P < .0001), and were twofold more likely to die in-hospital, even after adjustment for severity of illness (OR = 2.1; 95% CI, 1.2-3.6). Neither obesity nor gastroesophageal reflux was associated with aspiration.
  
  
  CONCLUSIONS
  Aspiration was more common in men with alcohol abuse history and a lower Glasgow Coma Scale who were admitted from a nursing home. It is independently associated with a significant increase in the risk for ARDS as well as morbidity and mortality. Findings from this study may facilitate the design of future clinical studies of aspiration-induced lung injury.
authors.affiliation: Department of Critical Care Medicine and Division of Pulmonary Medicine, Mayo Clinic Florida, Jacksonville, FL. Electronic address: lee.augustine@mayo.edu.
authors.forename: Augustine
authors.initials: A
authors.lastname: Lee
authors.affiliation: Department of Critical Care Medicine and Division of Pulmonary Medicine, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: Emir
authors.initials: E
authors.lastname: Festic
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Pauline K
authors.initials: PK
authors.lastname: Park
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Raghavendran
authors.affiliation: Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Missouri, Columbia, MO.
authors.forename: Ousama
authors.initials: O
authors.lastname: Dabbagh
authors.affiliation: Department of Anesthesiology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Adebola
authors.initials: A
authors.lastname: Adesanya
authors.affiliation: Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Ognjen
authors.initials: O
authors.lastname: Gajic
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, NC.
authors.forename: Raquel R
authors.initials: RR
authors.lastname: Bartz
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome