ArticleEuropean geriatric medicine2026
Low muscle mass as an independent risk factor for 30-day mortality among older inpatients with aspiration pneumonia: a nationwide cohort study.
Article in European geriatric medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo investigate whether low muscle mass is independently associated with adverse clinical outcomes in older adults hospitalized for aspiration pneumonia.
findingsLow muscle mass was highly prevalent in this population (89.4%), and severely low muscle mass was independently associated with increased 30-day mortality and readmission. In addition, a clear dose-response relationship was observed, with progressively lower muscle mass corresponding to worse clinical outcomes. MESSAGE: In older adults hospitalized for aspiration pneumonia, muscle mass assessment on admission may support risk stratification, and promoting awareness and maintenance of muscle health prior to hospitalization may also be important. PURPOSE: Aspiration pneumonia (AP) is highly prevalent in older adults and associated with adverse outcomes. This study aimed to clarify the association between low muscle mass and clinical outcomes in older adults with AP.
methodsThis cohort study used data from a nationwide claims database in Japan. Participants aged 65-99 years hospitalized for AP between April 2014 and November 2024 with a hospital stay of ≥ 3 days were included. Appendicular skeletal muscle mass was derived using a validated estimation equation standardized by height
resultsOverall, 25,611 patients were included (mean age, 85.1 years; 59.4% male). Based on the appendicular skeletal muscle mass index (ASMI), 10.6%, 37.2%, and 52.2% of the patients were classified as normal, moderately low, and severely low, respectively. After covariate adjustment, the severely low ASMI group had significantly higher 30-day mortality (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.22-1.63) and readmission risk (subdistribution HR, 1.47; 95% CI, 1.37-1.57) than the normal group.
conclusionLow muscle mass was observed in 89.4% of older adults hospitalized for AP and was independently associated with mortality. These findings underscore the importance of muscle mass assessment, prehospital nutritional care and efforts to maintain muscle health to improve outcomes.
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