Introduction and Objectives: Aspiration pneumonia is one of the diseases that patients with Parkinson’s disease (PD) most suffered from. Recently, incidence of aspiration pneumonia was increasing more than ever. Moreover, aspiration pneumonia accounts for the majority of death in PD patients. However, little is known about incidence and outcomes of aspiration pneumonia in patients with PD. Thus, we conducted a nationwide population-based study to investigate incidence and outcomes of aspiration pneumonia in PD patients.
Method: The National Health Insurance Service (NHIS) database covering the entire Korean population were analyzed to identify incident PD patients from 2004 to 2006 and to select 4 age- and sex-matched controls to each PD patient. We identified the occurrence of aspiration pneumonia and assess the risk factors of aspiration pneumonia in these matched cohort throughout the study period to 2017. We assessed mortality and the rate of gastrostomy insertion after occurrence of aspiration pneumonia.
Results: A total of 10159 incident PD patient and matched 39574 controls were identified. Throughout the 14 years of study period (2004–2017), the incidence of aspiration pneumonia was higher in the PD patients than the matched-controls (3.01 vs 0.59 events per 1,000 person-year). After adjusting confounders, the risk of aspiration pneumonia increased in PD patient (hazard ratio = 4.21; CI, 3.87-4.58). After occurrence of aspiration pneumonia, the mortality of patients with PD was 41.75% within 3 months, 65.22% within 1 year, 74.34% within 2 years. Within 3 months after aspiration pneumonia, 3.7% of patients received gastrostomy procedure. Older age, men, diabetes mellitus, congestive heart failure, tuberculosis, peripheral artery disease, chronic kidney disease, cerebrovascular disease and dementia were associated with higher risk of pneumonia.
Conclusion: To our knowledge, this is the first nationwide study of pneumonia in entire PD patients in the single country. PD patients had higher risk of experience of aspiration pneumonia, despite considering other confounders. Furthermore, about two-thirds of PD patients who have experienced aspiration pneumonia died within a year after the occurrence of aspiration pneumonia. Further research is needed for preventing aspiration pneumonia in PD patients and implementing proper measures to prevent death in PD patients after aspiration pneumonia. |
