LOW THORACIC SKELETAL MASS IS A RISK FACTOR FOR RECURRENCE OF ASPIRATION PNEUMONIA IN STROKE PATIENTS WITH DYSPHAGIA

SESSION TITLE: Outcomes in Pneumonia and NTMSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/17/2022 12:15 pm - 1:15 pmPURPOSE: This study aimed to investigate whether thoracic skeletal muscle mass index at the diagnosis of aspiration pneumonia is a predictor for the recurrence of aspiration pneumonia and to explore predicting factors for the recurrence of aspiration pneumonia in stroke patients with dysphagia disorder.METHODS: We retrospectively reviewed the data of patients with aspiration pneumonia who diagnosed with dysphagia disorder due to stroke from Jan. 2014 to Jul. 2020 in the Catholic University of Korea Bucheon St. Mary’s Hospital. Aspiration pneumonia was defined based on clinical signs of symptoms suggestive of pneumonia and radiologic findings of pneumonic infiltrations in the dependent portion of lung. We measured thoracic muscle volume by using the cross-sectional area (CSA) of the erector spinae muscle (ESMCSA , cm2) at the 12th vertebral region. Computed tomography scans at the time of diagnosis of aspiration pneumonia were used for analysis and respective CSA were divided by height squared (m2) to yield the muscle index at T12 (T12MI, cm2/m2) to normalize for stature. Multivariate logistic regression models were performed to investigate relationships between clinical parameters and recurrence of aspiration pneumonia.RESULTS: During study period, a total of 268 stroke patients with dysphagia disorder and developed aspiration pneumonia were analyzed. Mean T12MI of patients with and without recurrence of aspiration pneumonia was 708.1±229.9 cm2/m2 and 622.3±184.1 cm2/m2, respectively (P=0.001). Multivariate logistic regression revealed that lower T12MI (P=0.038) and older age (P=0.007) were the independent predictor of recurrence of aspiration pneumonia in stroke patients with dysphagia.CONCLUSIONS: Low thoracic muscle index at the diagnosis of aspiration pneumonia predicts recurrence of aspiration pneumonia in stroke patients with dysphagia.CLINICAL IMPLICATIONS: Prediction of any aspiration pneumonia in post-stroke dysphagic patients has been well reported. Those who once had AP are at repetitive risk of future respiratory events and poor clinical outcomes. Nevertheless, up to date, there are no guidelines on how to predict these recurrences. The T12MI can prove valuable in predicting those at risk of repetitive aspiration pneumonia and help provide strategies that may help prevent these recurrences. Future studies that identify the threshold values may help screen these patients with high accuracy are warranted.DISCLOSURES: no disclosure on file for Bo Mi Gil;No relevant relationships by Yujin Hongno disclosure on file for Sun Im;No relevant relationships by Hye Seon KangNo relevant relationships by JUNGHYUN NAM SESSION TITLE: Outcomes in Pneumonia and NTM SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: This study aimed to investigate whether thoracic skeletal muscle mass index at the diagnosis of aspiration pneumonia is a predictor for the recurrence of aspiration pneumonia and to explore predicting factors for the recurrence of aspiration pneumonia in stroke patients with dysphagia disorder. METHODS: We retrospectively reviewed the data of patients with aspiration pneumonia who diagnosed with dysphagia disorder due to stroke from Jan. 2014 to Jul. 2020 in the Catholic University of Korea Bucheon St. Mary’s Hospital. Aspiration pneumonia was defined based on clinical signs of symptoms suggestive of pneumonia and radiologic findings of pneumonic infiltrations in the dependent portion of lung. We measured thoracic muscle volume by using the cross-sectional area (CSA) of the erector spinae muscle (ESMCSA , cm2) at the 12th vertebral region. Computed tomography scans at the time of diagnosis of aspiration pneumonia were used for analysis and respective CSA were divided by height squared (m2) to yield the muscle index at T12 (T12MI, cm2/m2) to normalize for stature. Multivariate logistic regression models were performed to investigate relationships between clinical parameters and recurrence of aspiration pneumonia. RESULTS: During study period, a total of 268 stroke patients with dysphagia disorder and developed aspiration pneumonia were analyzed. Mean T12MI of patients with and without recurrence of aspiration pneumonia was 708.1±229.9 cm2/m2 and 622.3±184.1 cm2/m2, respectively (P=0.001). Multivariate logistic regression revealed that lower T12MI (P=0.038) and older age (P=0.007) were the independent predictor of recurrence of aspiration pneumonia in stroke patients with dysphagia. CONCLUSIONS: Low thoracic muscle index at the diagnosis of aspiration pneumonia predicts recurrence of aspiration pneumonia in stroke patients with dysphagia. CLINICAL IMPLICATIONS: Prediction of any aspiration pneumonia in post-stroke dysphagic patients has been well reported. Those who once had AP are at repetitive risk of future respiratory events and poor clinical outcomes. Nevertheless, up to date, there are no guidelines on how to predict these recurrences. The T12MI can prove valuable in predicting those at risk of repetitive aspiration pneumonia and help provide strategies that may help prevent these recurrences. Future studies that identify the threshold values may help screen these patients with high accuracy are warranted. DISCLOSURES: no disclosure on file for Bo Mi Gil; No relevant relationships by Yujin Hong no disclosure on file for Sun Im; No relevant relationships by Hye Seon Kang No relevant relationships by JUNGHYUN NAM