Characterization of increased aspiration pneumonia risk in patients with stroke

1. Aspiration pneumonia in post-stroke patients showed significantly increased 90-day mortality, longer hospital stays, and more cardiovascular events at one year

2. Stroke patients admitted to the medicine ward had increased pneumonia risk compared to stroke unit admission 

Evidence Rating Level: 2 (Good) 

This retrospective cohort study analyzed the impact of stroke severity on the risk of aspiration pneumonia in patients admitted to a stroke unit versus a general medical ward. Using data from the Qatar Stroke Database, 9,197 patients with acute ischemic stroke admitted between 2014 and 2024 were reviewed. The study compared clinical characteristics, 90-day mortality, functional outcomes (modified Rankin Scale), and hospital length of stay between stroke patients who developed aspiration pneumonia (4.1%) and those who did not (95.9%). Patients who developed aspiration pneumonia were older, more often male, and had significantly higher National Institute of Health Stroke Scale (NIHSS) scores at admission (p<0.001). Stroke subtype also influenced risk, with large vessel disease, cardioembolic stroke, and undetermined etiology associated with higher pneumonia rates. Patients with aspiration pneumonia had worse outcomes, including higher 90-day mortality (16.9% vs. 1.9% for NIHSS 5–9, p<0.001; 22.3% vs. 13.8% for NIHSS >10, p=0.003), longer hospital stays (16.0 vs. 5.3 days, p<0.001), and more adverse cardiovascular events at one year. Admission to a general medical ward increased pneumonia risk compared to stroke unit admission (adjusted OR 1.56, 95% CI: 1.05-2.31). The study highlights the importance of early dysphagia screening, targeted prevention strategies, and specialized stroke care in reducing aspiration pneumonia risk and improving patient outcomes.

Click to read the study in BMJ

Image: PD

©2025 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.