ArticleJournal of clinical medicine2022
A Paradigm Shift in the Diagnosis of Aspiration Pneumonia in Older Adults.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Factors driving outcome variability in aspiration and community-acquired pneumonia: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Trends in Hospitalization, Case Fatality, and Mortality for Community-Acquired Pneumonia in Portugal over 20 Years.Epidemiologia (Basel, Switzerland) · 2026Article
- Development of an interprofessional education program for aspiration pneumonia care: an action research study.European geriatric medicine · 2026Article
- Multifeature endoscopic swallowing patterns associated with pneumonia in hospitalized geriatric patients: a four-year longitudinal cohort study.BMC geriatrics · 2026Article
- Healthcare professionals' experiences and thoughts on eating and drinking with acknowledged risks in older adults: a comparison of Japan and the UK.Age and ageing · 2026Article
- Effect of positive end-expiratory pressure on risk of microaspiration and ventilator-associated pneumonia in mechanically ventilated ICU patients: a prospective study.Journal of cardiothoracic surgery · 2025Article
- Assessing the prevalence and the underdiagnosis of aspiration pneumonia among older hospitalized patients with community-acquired pneumonia using an artificial intelligence algorithm.Pneumonia (Nathan Qld.) · 2025Article
- Eating and Drinking with Acknowledged Risks (EDAR) in Older Adults: A Qualitative Study of the Experiences of Clinicians in Japan and the UK.Dysphagia · 2025Article
- Exploring the role of respiratory virus infections in aspiration pneumonia: a comprehensive analysis of cases with lower respiratory tract infections.BMC pulmonary medicine · 2025Article
- Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties.European geriatric medicine · 2024Article
- Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty?European geriatric medicine · 2024Article
- "Diagnose, Treat, and SUPPORT". Clinical competencies in the management of older adults with aspiration pneumonia: a scoping review.European geriatric medicine · 2024Article
- Importance of Skeletal Muscle and Interdisciplinary Team Approach in Managing Pneumonia in Older People.Journal of clinical medicine · 2023Article
- The Clinical Significance of Anaerobic Coverage in the Antibiotic Treatment of Aspiration Pneumonia: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Pneumonia, Aspiration Pneumonia, or Frailty-Associated Pneumonia?Geriatrics (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
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Abstract
In older adults, community-acquired pneumonia (CAP) is often aspiration-related. However, as aspiration pneumonia (AP) lacks clear diagnostic criteria, the reported prevalence and clinical management vary greatly. We investigated what clinical factors appeared to influence the diagnosis of AP and non-AP in a clinical setting and reconsidered a more clinically relevant approach. Medical records of patients aged ≥75 years admitted with CAP were reviewed retrospectively. A total of 803 patients (134 APs and 669 non-APs) were included. The AP group had significantly higher rates of frailty, had higher SARC-F scores, resided in institutions, had neurologic conditions, previous pneumonia diagnoses, known dysphagia, and were more likely to present with vomiting or coughing on food. Nil by mouth orders, speech therapist referrals, and broad-spectrum antibiotics were significantly more common, while computed tomography scans and blood cultures were rarely performed; alternative diagnoses, such as cancer and pulmonary embolism, were detected significantly less. AP is diagnosed more commonly in frail patients, while aspiration is the underlying aetiology in most types of pneumonia. A presumptive diagnosis of AP may deny patients necessary investigation and management. We suggest a paradigm shift in the way we approach older patients with CAP; rather than trying to differentiate AP and non-AP, it would be more clinically relevant to recognise all pneumonia as just pneumonia, and assess their swallowing functions, causative organisms, and investigate alternative diagnoses or underlying causes of dysphagia. This will enable appropriate clinical management.
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