title: National Trends in Admission for Aspiration Pneumonia in the United States, 2002-2012.
abstract: BACKGROUND
  Aspiration pneumonia is a subset of pneumonias prevalent in elderly patients and patients with neurologic disorders. Researchers in previous studies mostly reported incidence and/or mortality rates based on regional data or in specific subgroups of patients. There is a paucity of nationwide data in the contemporary U.S.
  
  
  METHODS
  
  
  
  OBJECTIVE
  To describe U.S. national trends in acute care hospital admission for aspiration pneumonia from 2002 to 2012.
  
  
  METHODS
  We used the U.S. National (Nationwide) Inpatient Sample database to identify patients admitted with a primary diagnosis of aspiration pneumonia between 2002 and 2012. We estimated trends in the incidence, in-hospital mortality, length of stay, and total hospitalization cost for patients admitted for aspiration pneumonia and stratified on the basis of patient age (≥65 yr vs. <65 yr). Multivariable logistic regression analysis was used to identify independent predictors for in-hospital mortality.
  
  
  RESULTS
  A total of 406,798 patients (weighted total, 1,741,517) admitted for aspiration pneumonia were included in this study. There were 84,200 (20.7%) patients younger than 65 years of age and 322,598 patients (79.3%) aged 65 years or older. From 2002 to 2012, the overall incidence of aspiration pneumonia decreased from 8.2 to 7.1 cases per 10,000 people, and in-hospital mortality decreased from 18.6 to 9.8%. For patients aged 65 years or older, the incidence decreased from 40.7 to 30.9 cases per 10,000 people, and the in-hospital mortality decreased from 20.7 to 11.3%. The median total hospitalization charges increased in both groups (age ≥65 yr, from $16,173 to $30,280; age <65 yr, from $17,517 to $30,526). In multivariable logistic analysis, patients aged 65 years or older or treatment in a nonteaching hospital were independent predictors of in-hospital mortality.
  
  
  CONCLUSIONS
  The incidence and mortality of patients admitted to acute care hospitals for aspiration pneumonia decreased between 2002 and 2012 in the United States. This difference was more evident for elderly patients. However, the cost of hospitalization almost doubled. Being older than 65 years of age is an independent predictor of in-hospital mortality among patients admitted for aspiration pneumonia. Strategies to prevent aspiration pneumonia in the community should be implemented in the aging U.S.
  
  
  METHODS
authors.affiliation: 1 Department of Medicine, Jacobi Medical Center, Bronx, New York.
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Wu
authors.affiliation: 2 Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts; and.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: 3 Department of Epidemiology, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
authors.forename: Min-Jung
authors.initials: MJ
authors.lastname: Wang
authors.affiliation: 1 Department of Medicine, Jacobi Medical Center, Bronx, New York.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pinelis
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005544:Forecasting; D017722:Hospital Charges / Q000706:statistics & numerical data / Q000639:trends*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011015:Pneumonia, Aspiration / Q000191:economics / Q000401:mortality*; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: NIS; aspiration; aspiration pneumonia; national trends; pneumonia