Aspiration occurs when oropharyngeal or gastric contents are inhaled into the larynx and lower respiratory tract. When the aspirated material is colonised by pathogenic microorganisms, this may result in aspiration pneumonia. In contrast, aspiration of sterile gastric contents may lead to aspiration pneumonitis, characterised by inflammatory injury without infection. Aspiration pneumonia is highly prevalent, particularly among frail adults and those in institutionalised care settings, and remains a significant contributor to morbidity and healthcare burden. In this scoping review, the authors examined risk factors most strongly associated with aspiration pneumonia in adults. Fifty-six primary studies met the inclusion criteria, with sample sizes ranging from 20 to 610,668 participants and encompassing adults aged 18 to 99 years. Across these studies, the authors identified 132 variables associated with the development of aspiration pneumonia. Dysphagia emerged as the most frequently reported risk factor, cited in 29 studies and accounting for over half (53%) of the identified associations. Other commonly reported risk factors included neurological impairment, dementia, head and neck malignancies, diabetes mellitus, chronic respiratory disease, and tobacco and alcohol use. Increased vulnerability was also associated with prolonged use of respiratory support devices, gastro oesophageal reflux disease, and broader indicators of frailty and physiological decline related to ageing. The paper includes a summary figure mapping the identified risk factors alongside the number of studies in which they were reported. This visual synthesis provides a concise overview of the evidence base and serves as a useful signposting tool for clinicians, researchers and policy makers seeking to prioritise risk assessment or explore specific factors in greater depth.
Predicting aspiration pneumonia in adults
Reviewed by Roganie Govender
Risk Factors Associated to Aspiration Pneumonia in Adults and Elderly Patients: A Scoping Review.
CONTRIBUTOR
Roganie Govender
University College London, Head & Neck Academic Centre, UK.
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