Evidence map›Paper›PMID 41062168›Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2025

Factors driving outcome variability in aspiration and community-acquired pneumonia: a meta-analysis.

Jordi Almirall, Ramón Boixeda, Mari C de la Torre, Marcial Cariqueo, Antoni Torres

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jordi AlmirallIntensive Care Unit, Hospital Universitari de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain jalmirall@csdm.cat.ORCID https://orcid.org/0000-0002-3821-4341
Ramón BoixedaGEMPAC Respiratory Infection Reserch Group, Barcelona, Spain.
Mari C de la TorreIntensive Care Unit, Hospital Universitari de Mataró, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.
Marcial CariqueoCELLEX research laboratories, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Antoni TorresCentro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.ORCID https://orcid.org/0000-0002-8643-2167

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAspiration community-acquired pneumonia (ACAP) is common among older adults and is associated with worse outcomes than nonaspiration community-acquired pneumonia (CAP). Understanding these differences is essential for improving patient care.

objectivesTo determine the prevalence of ACAP among pneumonia patients and compare clinical outcomes, including hospital length of stay, intensive care unit (ICU) admissions and mortality rates, between patients with ACAP and those with CAP.

methodsA systematic review and meta-analysis were conducted following MOOSE (Meta-Analysis of Observational Studies in Epidemiology) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Literature searches in PubMed, Embase and Google Scholar from January 1995 to January 2024 identified studies involving adults diagnosed with CAP or ACAP. Data extraction and quality assessment were performed independently by two reviewers. Random-effects meta-analysis and meta-regression analyses were conducted to identify sources of heterogeneity.

results49 samples from 44 studies were included, encompassing 1 277 615 older adults (mean age 80.2 years). The pooled prevalence of ACAP was 25% (95% CI 19-31) and higher in studies with a mean age of 70 years or older at 32% (95% CI 25-39). Compared to CAP patients, those with ACAP had significantly longer hospital stays (mean difference 4.92 days, 95% CI 4.71-5.14), increased ICU admissions (risk ratio 2.33, 95% CI 1.77-3.07), higher in-hospital mortality (risk ratio 2.14, 95% CI 1.73-2.65), higher 30-day mortality (risk ratio 2.56, 95% CI 2.12-3.1), higher 1-year mortality (risk ratio 1.96, 95% CI 1.44-2.66) and greater recurrence rates (risk ratio 1.75, 95% CI 1.44-2.66). Meta-regression identified publication year, patient age, study design, nursing home residency and compliance with therapeutic guidelines as significant moderators explaining heterogeneity.

conclusionsPatients with ACAP experience significantly worse clinical outcomes than those with CAP. These findings highlight the importance of early identification and management of aspiration risks, adherence to therapeutic guidelines and the need for standardised diagnostic criteria to improve outcomes in this vulnerable population.

Indexed as

Community-Acquired InfectionsPneumoniaPneumonia, AspirationAgedAged, 80 and overAge FactorsCommunity-Acquired PneumoniaFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedPatient AdmissionPrevalence

Identifiers

PMID41062168
PMCPMC12505152

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.