Risk of aspiration pneumonia and hospital mortality in Parkinson disease: A systematic review and meta-analysis

Background and Purpose

This study was undertaken to conduct a meta-analysis on the prevalence of aspiration pneumonia (AP) and hospital mortality in Parkinson disease (PD) as well as the risk of AP in PD patients compared to controls.

Methods

We searched MEDLINE and Embase from inception to 19 March 2024 to identify cross-sectional, cohort, and case–control studies comparing the frequency of AP and hospital mortality in PD patients. We computed risk ratios (RRs) with accompanying 95% confidence intervals (CIs) for each study and pooled the results using a random-effects meta-analysis.

Results

A total of 781 studies were initially screened, and 13 studies involving 541,785,587 patients were included. Patients with PD had >3 times higher risk of AP compared to controls (RR = 3.30, 95% CI = 1.82–6.00, p < 0.0001). This increased risk was similar in both cohort studies (RR = 3.01, 95% CI = 1.10–8.24, p = 0.03) and case–control studies (RR = 3.86, 95% CI = 3.84–3.87, p < 0.00001). The prevalence of AP in 12 studies was 2.74% (95% CI = 1.69–4.41), and hospital mortality was 10% in six studies (10.0%, 95% CI = 5.32–18.0). Prevalence of AP was higher in studies with smaller sample size (5.26%, 95% CI = 3.08–8.83 vs. 2.06%, 95% CI = 1.19–3.55, p = 0.02).

Conclusions

Our meta-analysis showed that patients with PD had >3 times higher risk of AP, with an average 2.74% prevalence and 10.0% hospital mortality. Early recognition and treatment of AP in PD patients will help reduce morbidity and mortality. A multidisciplinary holistic approach is needed to address the multifactorial causes of AP.