INTRODUCTION
Aspiration pneumonia is a clinical syndrome that often develops in
patients with impaired swallowing function and cough reflex or those
with underlying diseases associated with dysphagia such as
cerebrovascular diseases, dementia, and Parkinson’s
disease.1 Concomitant with aging of the population,
the incidence of aspiration pneumonia in older adults is increasing and
is associated with higher mortality rates. Indeed, aspiration pneumonia
accounts for 70% of pneumonia in patients aged ≥70
years.2 Despite its high morbidity and mortality,
clinical features and prognostic factors for aspiration pneumonia in
older patients remain poorly defined.
Current clinical guidelines for pneumonia emphasize optimal antibiotic
strategies based on estimated causative pathogens.3-5Based on these guidelines, the location of infection and several risk
factors are utilized to determine the appropriate treatment strategy and
prognostic evaluation. Nevertheless, these algorithms may be unsuitable
for patients with aspiration pneumonia owing to the heterogeneity of
this patient population.6
Older adults commonly experience nutritional issues associated with
declining organ and physical functions, underlying diseases, and
inadequate dietary habits.7 In hospitalized settings
for older individuals, undernutrition is associated with poor clinical
outcomes such as longer hospital stay and higher mortality
rate.8,9 Thus,
in geriatric clinical practice, the assessment of nutritional status is
crucial for improving prognosis and anticipating subsequent clinical
course. The geriatric nutritional risk index (GNRI) is a simple and
objective index proposed by Bouillanne et al. to evaluate nutritional
risk in hospitalized older patients.10 GNRI was
recently reported to be a useful tool for predicting mortality in older
patients with hemodialysis,11 heart
failure,12 various cancers,13-15 and
trauma.16 Wei et al. reported that GNRI demonstrated
superior predictive value for poor prognosis compared with other
inflammatory indicators in older patients with severe community-acquired
pneumonia (CAP).17 Nevertheless, the prognostic
utility of GNRI in older patients with aspiration pneumonia remains
unclear. Therefore, this study aimed to investigate the prognostic
utility of GNRI in older patients with aspiration pneumonia.