title: Aspiration-related deaths in 57 consecutive patients: autopsy study.
abstract: BACKGROUND
  Aspiration can cause a diverse spectrum of pulmonary disorders some of which can lead to death but can be difficult to diagnose.
  
  
  METHODS
  The medical records and autopsy findings of 57 consecutive patients in whom aspiration was the immediate cause of death at Mayo Clinic (Rochester, MN, USA) over a 9-yr period, from January 1 2004 to December 31 2012 were analyzed.
  
  
  RESULTS
  The median age at death was 72 years (range, 13-95 years) and included 39 (68%) males. The most common symptom before death was dyspnea (63%) and chest radiography revealed bilateral infiltrates in the majority (81%). Most common precipitating factors for aspiration were depressed consciousness (46%) and dysphagia (44%). Aspiration-related syndromes leading to death were aspiration pneumonia in 26 (46%), aspiration pneumonitis in 25 (44%), and large airway obstruction in 6 patients (11%). Aspiration was clinically unsuspected in 19 (33%) patients. Antimicrobial therapy had been empirically administered to most patients (90%) with aspiration pneumonia and aspiration pneumonitis.
  
  
  CONCLUSIONS
  We conclude aspiration-related deaths occur most commonly in the elderly with identifiable risks and presenting bilateral pulmonary infiltrates. One-third of these aspiration-related pulmonary syndromes were clinically unsuspected at the time of death.
authors: Department of Respiratory Medicine, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
authors: Xiaowen
authors: X
authors: Hu
authors: Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Eunhee S
authors: ES
authors: Yi
authors: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Jay H
authors: JH
authors: Ryu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000401:mortality*; D016019:Survival Analysis; D055815:Young Adult