ArticleJournal of intensive care2026
Aspiration pneumonia in the world's most aged society: age-stratified ICU management and outcomes from a nationwide Japanese registry.
Article in Journal of intensive care, 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
objectivesTo describe the age-stratified clinical characteristics, ICU management, and in-hospital outcomes of adults admitted to Japanese ICUs with aspiration pneumonia.
designMulticenter, retrospective, observational cohort study.
settingMultiple ICUs participated in the Japanese Intensive Care Patient Database (JIPAD), a nationwide registry of the Japanese Society of Intensive Care Medicine, from 2015 to 2023. PATIENTS: Adults ≥ 18 years admitted to ICUs with a primary diagnosis of aspiration pneumonia. MEASUREMENTS AND MAIN
resultsAmong 3,906 eligible ICU admissions (median age, 76 years [IQR, 68-83]; 75.5% male), illness severity at admission increased with age (median APACHE III score, 74 [56-91] in patients aged 18-64 years vs. 96 [81-120] in those aged ≥ 85 years). Invasive mechanical ventilation (MV) was used in 68.8% of patients and was less frequent in older age groups (18-64 years: 73.2%; 65-74 years: 74.2%; 75-84 years: 69.9%; ≥ 85 years: 55.4%). Overall in-hospital mortality was 28.3% and increased across age groups (18-64 years: 13.7%; 65-74 years: 25.0%; 75-84 years: 32.1%; ≥ 85 years: 39.3%). Median hospital and ICU lengths of stay were 32 days (IQR, 16-58) and 120.4 h (IQR, 54.4-234.8), respectively. In-hospital pathways differed markedly across age groups: among patients aged ≥ 85 years, in-hospital mortality reached 39.3%, and home discharge was achieved in only 19.9%, compared with 13.7% and 45.2% among patients aged 18-64 years, respectively. In the exploratory adjusted analyses, the probability of in-hospital mortality increased with age, whereas that of MV use decreased, particularly in patients aged > 75 years.
conclusionsOlder patients with aspiration pneumonia had higher illness severity yet received less MV, and had higher in-hospital mortality and lower home discharge rates. These nationwide data describe the current state of ICU-managed aspiration pneumonia in a super-aged society and may provide a reference point for future comparative studies.
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