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Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis

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Abstract

Background

Although all types of endoscopic procedures harbor risk of aspiration, little is understood about risk factors for aspiration pneumonia developing after endoscopic hemostasis.

Aims

The present study aimed to identify risk factors for aspiration pneumonia after endoscopic hemostasis.

Methods

Charts from consecutive patients with upper gastrointestinal bleeding that had been treated by endoscopic hemostasis at a single center between January 2004 and January 2015 were retrospectively reviewed. Patient information and clinical characteristics including cause of hemorrhage, established prognostic scales, laboratory data, comorbidities, medications, duration of endoscopic hemostasis, vital signs, sedative use, and the main operator during the procedure were compared between patients who developed aspiration pneumonia and those who did not.

Results

Aspiration pneumonia developed in 24 (4.8 %) of 504 patients after endoscopic hemostasis. Endotracheal intubation was required for three of them, and one died of the complication. Multivariate analysis revealed that age >75 years (odds ratio (OR) 4.4; 95 % confidence interval (CI) 1.5–13.6; p = 0.0073), procedural duration >30 min (OR 5.6; 95 % CI 1.9–18.2; p = 0.0023), hemodialysis (OR 3.6; 95 % CI 1.2–11; p = 0.024), and a history of stroke (OR 3.8; 95 % CI 1–14; p = 0.041) were independent risk factors for developing aspiration pneumonia.

Conclusions

Specific risk factors for aspiration pneumonia after endoscopic hemostasis were identified. Endoscopists should carefully consider aspiration pneumonia when managing older patients who are on hemodialysis, have a history of stroke, and undergo a longer procedure.

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Abbreviations

ESD:

Endoscopic submucosal dissection

GI:

Gastrointestinal

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Authors and Affiliations

  1. Department of Gastroenterology, Mitsui Memorial Hospital, 1 Kanda-Izumi-cho, Chiyoda-ku, Tokyo, 101-8643, Japan

    Koki Kawanishi, Nobuo Toda, Mari Yamagami, Tomoharu Yamada, Kentaro Kojima, Takamasa Ohki, Michiharu Seki & Kazumi Tagawa

  2. Second Department of Internal Medicine, Wakayama Medical University, 811 Kimiidera, Wakayama City, Wakayama, 641-0012, Japan

    Jun Kato

Authors
  1. Koki Kawanishi
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  2. Jun Kato
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  3. Nobuo Toda
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  4. Mari Yamagami
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  5. Tomoharu Yamada
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  6. Kentaro Kojima
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  7. Takamasa Ohki
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  8. Michiharu Seki
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  9. Kazumi Tagawa
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Corresponding author

Correspondence to Jun Kato.

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The authors have no conflicts of interest to declare in relation to this study.

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Kawanishi, K., Kato, J., Toda, N. et al. Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis. Dig Dis Sci 61, 835–840 (2016). https://doi.org/10.1007/s10620-015-3941-0

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  • DOI: https://doi.org/10.1007/s10620-015-3941-0

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