title: Incidence and mortality trends of aspiration pneumonia in Parkinson's disease in the United States, 1979-2010.
abstract: BACKGROUND
  Careful examination of long-term analyses and trends is essential in understanding the medico-economic burden of this common complication. We sought to describe the long-term (32-year) trends of incidence and mortality in PD patients hospitalized with aspiration pneumonia (AsPNA).
  
  
  METHODS
  Incidence and mortality of AsPNA in hospitalized PD versus non-PD patients was assessed by logistic regression analysis applied to a national database between the years 1979 and 2010. Covariates such as age-decennium, gender, year AsPNA occurred, and the interactions with PD diagnosis were investigated. Rate of AsPNA and mortality over the 32-years was trended and compared.
  
  
  RESULTS
  AsPNA occurred in 3.6% of PD patients and 1.0% of non-PD patients. The average mortality for PD patients was less (17% vs. 22%). Long-term (32-year) trends revealed a nearly 10-fold increase in incidence of AsPNA in PD (0.4% in 1979, 4.9% in 2010), decreasing mortality overtime, higher likelihood in males, and increasing average age of AsPNA patients (steeper increase in PD). All p-values<0.05. In regression analysis, each successive year had a slight increase in odds of AsPNA (OR 1.03 in PD, OR1.06 in non-PD).
  
  
  CONCLUSIONS
  Trends over 32 years revealed a 10-fold increase in AsPNA among PD and non-PD patients, and an associated decrease in mortality. Our data suggest that PD patients are living longer, have slightly more AsPNA, but a lower mortality than was seen in past decades. Further research should investigate the causes of AsPNA in PD, and also potential interventions to decrease its occurrence.
authors.affiliation: Department of Neurology, Brown University, Providence, RI, USA.
authors.forename: Umer
authors.initials: U
authors.lastname: Akbar
authors.affiliation: Department of Neurology, Drexel University, Philadelphia, PD, USA.
authors.forename: Bhavpreet
authors.initials: B
authors.lastname: Dham
authors.affiliation: Department of Mathematics, Clarkson University, NY, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: He
authors.affiliation: US Naval Hospital, Okinawa, Japan.
authors.forename: Nawaz
authors.initials: N
authors.lastname: Hack
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Speech and Language Pathology, University of Florida, Gainesville, FL, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Troche
authors.affiliation: Department of Anesthesiology, University of Florida, Gainesville, FL, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tighe
authors.affiliation: Community & Family Medicine and of Dartmouth Institute, NH, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Nelson
authors.affiliation: Department of Neurology, Brown University, Providence, RI, USA.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Friedman
authors.affiliation: Department of Neurology, University of Florida, Gainesville, FL, USA. Electronic address: okun@neurology.ufl.edu.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology* / Q000401:mortality*; D011015:Pneumonia, Aspiration / Q000453:epidemiology* / Q000401:mortality*; D017678:Sex Distribution; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: Aspiration; Complications; Dysphagia; Morbidity; Mortality; Parkinson's disease; Pneumonia; Prognosis; Swallowing