Abstract
Objective: Designing an efficient management strategy for aspiration is of high priority in our aging society because of its high incidence. We evaluated the prognostic value of both the A-DROP (age, dehydration, respiratory, disorientation, and pressure) and the modified A-DROP scoring systems (adding respiratory rate and comorbidity to A-DROP) in patients with aspiration pneumonia.
Design: This is a retrospective study using electronic medical records at Saitama Medical University (SMU) hospital.
Setting: A 965-bed university tertiary medical center in Japan.
Participants: Data were extracted from the electronic medical records of patients from SMU hospital.
Methods: In-hospital mortality was compared between two groups: 1) those with a ‘severe’ to ‘advanced severe’ A-DROP score; and 2) those with a ‘low’ to ‘middle’ A-DROP score. Area under the curve (AUC) for mortality for both the A-DROP and modified A-DROP scoring systems were compared.
Results: The in-hospital mortality rates for patients with a high and a low A-DROP score were 28.6% and 9.0%. The mortality rates in the high modified A-DROP score group and in the low modified A-DROP score group were 28.2% and 9.9%. These differences in the mortality rates between the two groups were statistically significant for both the A-DROP and the modified A-DROP scoring systems. The AUC of the receiver operating characteristics curve for the A-DROP (0.700; 95% confidence interval, 0.608-0.779) was statistically significant.
Conclusion: The A-DROP and modified A-DROP scoring systems are associated with in-hospital mortality in patients with aspiration pneumonia. The A-DROP scoring system is easy to use and may be a clinically valuable tool in the management of aspiration pneumonia.
Footnotes
There is no financial support for this study.
- Received February 17, 2020.
- Revision received November 16, 2020.
- Accepted December 9, 2020.
