Impact of Living Place on the Prognosis of Aspiration Pneumonia in Elderly Patients: A Retrospective Study in Tokyo.

Introduction In Japan, aspiration pneumonia is a major cause of death among the elderly. While clinical factors are well-documented, the impact of social factors on the prognosis of aspiration pneumonia remains underexplored. This study investigates whether social factors, such as living place and caregiver presence, influence the prognosis of aspiration pneumonia. Methods This retrospective study analyzed patients aged 65 and older admitted for aspiration pneumonia at our hospital from January 2012 to December 2022. The study included 650 patients after excluding those with pneumonia onset after admission, interstitial pneumonia, and cancer or those on immunosuppressants. Clinical data, including age, sex, comorbidities, and Pneumonia Patient Outcomes Research Team (PORT) score, were collected alongside social factors such as the level of care needed, living place, and cohabitant number at home. We performed univariate and multivariable analyses to assess the relationship between these factors and mortality rates. Results The overall mortality rate was 18.6%. Significant differences were found in age, sex, congestive heart failure, and PORT score between survivors and non-survivors. Multivariable analysis revealed that residing in a nursing home is associated with a lower mortality rate than living at home (odds ratio, 0.62; 95% CI, 0.40-0.95). On the other hand, patients living at home with two or more cohabitants had a higher mortality rate than those in nursing homes, although this was not statistically significant (odds ratio, 1.67; 95% CI, 0.94-2.94). Discussion The study indicates that residing in a nursing home may improve the prognosis of aspiration pneumonia. Patients at home may experience delayed medical attention and less effective preventive measures than those in nursing homes. Conclusion Social factors, particularly the patient's living place, impact the prognosis of aspiration pneumonia. Enhanced caregiving in a nursing home may contribute to a better prognosis, emphasizing the need for improved home care strategies.