Journal of Intensive Care · Published 2026-08-01 · DOI 10.1186/s40560-026-00923-1
Satoru Sekiya, Shunsaku Goto, Hiromu Okano, Hiroshi Okamoto
Abstract Objectives To describe the age-stratified clinical characteristics, ICU management, and in-hospital outcomes of adults admitted to Japanese ICUs with aspiration pneumonia. Design Multicenter, retrospective, observational cohort study. Setting Multiple ICUs participated in the Japanese Intensive Care Patient Database (JIPAD), a nationwide registry of the Japanese Society of Intensive Care Medicine, from 2015 to 2023. Patients Adults ≥ 18 years admitted to ICUs with a primary diagnosis of aspiration pneumonia. Measurements and main results Among 3,906 eligible ICU admissions (median age, 76 years [IQR, 68–83]; 75.5% male), illness severity at admission increased with age (median APACHE III score, 74 [56–91] in patients aged 18–64 years vs. 96 [81–120] in those aged ≥ 85 years). Invasive mechanical ventilation (MV) was used in 68.8% of patients and was less frequent in older age groups (18–64 years: 73.2%; 65–74 years: 74.2%; 75–84 years: 69.9%; ≥ 85 years: 55.4%). Overall in-hospital mortality was 28.3% and increased across age groups (18–64 years: 13.7%; 65–74 years: 25.0%; 75–84 years: 32.1%; ≥ 85 years: 39.3%). Median hospital and ICU lengths of stay were 32 days (IQR, 16–58) and 120.4 h (IQR, 54.4–234.8), respectively. In-hospital pathways differed markedly across age groups: among patients aged ≥ 85 years, in-hospital mortality reached 39.3%, and home discharge was achieved in only 19.9%, compared with 13.7% and 45.2% among patients aged 18–64 years, respectively. In the exploratory adjusted analyses, the probability of in-hospital mortality increased with age, whereas that of MV use decreased, particularly in patients aged > 75 years. Conclusions Older patients with aspiration pneumonia had higher illness severity yet received less MV, and had higher in-hospital mortality and lower home discharge rates. These nationwide data describe the current state of ICU-managed aspiration pneumonia in a super-aged society and may provide a reference point for future comparative studies.
Abstract from DOAJ. Public domain (CC0 1.0).
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Sekiya, S., Goto, S., Okano, H., et al. (2026). Aspiration pneumonia in the world's most aged society: age-stratified ICU management and outcomes from a nationwide Japanese registry. Journal of Intensive Care. https://doi.org/10.1186/s40560-026-00923-1