Digestive Diseases and Sciences

, Volume 61, Issue 3, pp 835–840 | Cite as

Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis

  • Koki Kawanishi
  • Jun Kato
  • Nobuo Toda
  • Mari Yamagami
  • Tomoharu Yamada
  • Kentaro Kojima
  • Takamasa Ohki
  • Michiharu Seki
  • Kazumi Tagawa
Original Article



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


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


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.


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.


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.


Conscious sedation Emergency endoscopy Hemodialysis Procedure time Stroke Upper gastrointestinal bleeding 



Endoscopic submucosal dissection




Compliance with ethical standards

Conflict of interest

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


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Koki Kawanishi
    • 1
  • Jun Kato
    • 2
  • Nobuo Toda
    • 1
  • Mari Yamagami
    • 1
  • Tomoharu Yamada
    • 1
  • Kentaro Kojima
    • 1
  • Takamasa Ohki
    • 1
  • Michiharu Seki
    • 1
  • Kazumi Tagawa
    • 1
  1. 1.Department of GastroenterologyMitsui Memorial HospitalChiyoda-kuJapan
  2. 2.Second Department of Internal MedicineWakayama Medical UniversityWakayama CityJapan

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