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Original Article

Author(s): Alam MS, Sikandar A, Sultana T, Shaheen MMR

PAH Med Col J. Jul 2024; 1(1): 2-7

Abstract

Background: Aspiration is a well-established cause of pulmonary disease and frequently occurs in patients with altered consciousness. Mortality from aspiration pneumonia ranges from approximately 1% in outpatient settings to as high as 25% in hospitalized patients, and can reach up to 70% if not properly managed. Currently, there is no national-level study on aspiration pneumonia among hospitalized stroke patients with impaired consciousness.

Objective: This study aimed to determine the prevalence of aspiration pneumonia in stroke patients with altered consciousness admitted to the medicine department of President Abdul Hamid Medical College Hospital (PAHMCH).

Methods: A prospective observational study was conducted from May 2018 to March 2019, including 52 adult stroke patients with altered consciousness who developed aspiration pneumonia.

Results: Among them, 76.92% developed pneumonitis, 13.46% developed lung abscesses, and 9.62% developed acute respiratory distress syndrome (ARDS). Radiologically, 33 patients had opacities in the right lower lung zone, 13 in the left lower zone, 6 in the right midzone, and 10 patients had bilateral lower-zone opacities. The overall mortality rate was 23%. Mortality was 8.33% when only one lobe was involved, whereas involvement of two or more lobes was associated with mortality ranging from 25% to 91%.

Conclusion: Physicians and healthcare personnel can reduce the incidence of aspiration pneumonia by ensuring that comatose patients are not left unattended, checking nasogastric tube placement, positioning patients properly, administering tube feeds at an appropriate rate, and adhering to routine patient care precautions.

Keywords

Aspiration pneumonia, Pulmonary involvement, Stroke with altered consciousness

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How to cite: Alam MS, Sikandar A, Sultana T, Shaheen MMR. Prevalence and Outcomes of Aspiration Pneumonia in Stroke Patients with Altered Consciousness Admitted in a Medical College Hospital of Haor District of Bangladesh. PAH Med Col J. Jul 2024; 1(1): 2-7.