A68-17 Factors Associated With Poor Prognosis Despite Endotracheal Intubation in Patients With Aspiration Pneumonia: A Nationwide Database Study in Japan

Rationale Aspiration pneumonia is associated with high mortality, particularly in older adults. Although endotracheal intubation is often performed for severe cases, the prognosis of aspiration pneumonia patients who undergo intubation remains unclear. This study aimed to identify risk factors associated with mortality in aspiration pneumonia patients who underwent endotracheal intubation. Methods This retrospective cohort study used the nationwide Diagnosis Procedure Combination (DPC) database in Japan. Patients aged ≥65 years who were hospitalized with aspiration pneumonia between January and December 2018 were included. We analyzed patients who underwent endotracheal intubation within three days of admission. Logistic regression analyses were performed to identify factors associated with 30-day mortality. Results Among 67,739 patients hospitalized for aspiration pneumonia, 1,764 (2.6%) underwent endotracheal intubation within three days of admission. Of these, 361 (20%) died within 30 days. Compared with survivors, non-survivors were older and had higher proportions of males, current or former smokers, and patients with interstitial pneumonia or steroid/immunosuppressive use. Multivariate analysis identified advanced age (adjusted odds ratio [aOR] 1.05; 95% CI [confidence interval] 1.03-1.06), male sex (aOR 0.68 for female; 95% CI 0.52-0.89), and a history of interstitial pneumonia (aOR 3.45; 95% CI 1.47-8.07) as independent risk factors for 30-day mortality. Conclusions Advanced age, male sex, and interstitial pneumonia were significantly associated with mortality in aspiration pneumonia patients undergoing early intubation. These findings highlight the need for careful evaluation of the indications for intubation in older patients with these characteristics. This abstract is funded by: None