title: Muscle Mass Loss Is a Potential Predictor of 90-Day Mortality in Older Adults with Aspiration Pneumonia.
abstract: To investigate the association between loss of muscle mass and aspiration pneumonia (AP).
  
  
  
  Prospective observational cohort.
  
  
  
  Acute geriatric hospital.
  
  
  
  Individuals admitted to the hospital for AP (N = 151; mean age 85.9; 49.7% male).
  
  
  
  Appendicular skeletal muscle index (ASMI; appendicular skeletal muscle mass divided by height squared) was used to evaluate muscle mass. Data on age, sex, body mass index, Mini Nutritional Assessment-Short Form score, Barthel Index score, Charlson Comorbidity Index score, and pneumonia severity (Japanese version of the CURB-65 (C (confusion), U (blood urea nitrogen ≥20 mg/dL), R (respiratory rate ≥30 breaths/min), B (systolic blood pressure <90 mmHg or diastolic blood pressure ≤60 mmHg), 65 (aged ≥65) severity score (A-DROP)) were obtained. Outcomes included 30- and 90-day mortality.
  
  
  
  Mild, moderate, severe, and extremely severe AP were observed in 1.3%, 70.2%, 25.8%, and 2.6% of participants, respectively. On Kaplan-Meier analysis, participants in the lowest ASMI quartile for each sex were more likely to die than those in the other quartiles (log-lank test P = .005). Multivariate logistic analyses showed that ASMI and A-DROP were independent predictors of 90-day mortality; only A-DROP was a significant predictor of 30-day mortality (P < .001). Cox regression analysis also showed that the first ASMI quartile was independently associated with mortality (hazard ratio = 2.19; 95% confidence interval = 1.06-4.52; P = .03).
  
  
  
  Low muscle mass is a potential predictor of long-term mortality in individuals with AP. Prospectively preventing muscle mass deterioration may be beneficial for recovery from AP in older adults.
authors.affiliation: Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, Japan.
authors.forename: Keisuke
authors.identifier: 0000-0001-7132-7818
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Tamana Regional Health Medical Center, Kumamoto, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Akagi
mesh_terms: D000369:Aged, 80 and over; D001823:Body Composition; D015331:Cohort Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D018482:Muscle, Skeletal / Q000033:anatomy & histology*; D011015:Pneumonia, Aspiration / Q000401:mortality*; D055948:Sarcopenia / Q000175:diagnosis*
keywords: aspiration pneumonia; mortality; sarcopenia; skeletal muscle mass