Data from: Impact of aspiration pneumonia on the clinical course of progressive supranuclear palsy: a retrospective cohort study

Introduction: Although aspiration pneumonia is the most common
complication of progressive supranuclear palsy (PSP), the clinical impact
of aspiration pneumonia on disease course and survival has not been fully
estimated. Thus, we retrospectively analyzed the prognostic factors and
clinical consequences of pneumonia in PSP. Methods: The clinical course of
patients with aspiration pneumonia was surveyed. The association between
baseline clinical features (2 years from disease onset) and latency to the
initial development of pneumonia was investigated using survival time and
Cox regression analyses. Results: Ninety patients with a clinical
diagnosis of PSP were observed for 5.1±3.8 years (mean±SD), and 22 had
aspiration pneumonia. Subsequently, 20 patients (91%) had to discontinue
oral feeding entirely and 13 (59%) died, whereas, of 68 patients without
pneumonia, only three patients (4%) died. Time to initial development of
pneumonia was strongly correlated with survival time (Spearman R = 0.92,
P<0.001), with a mean latency of 2.3 years to death. Among baseline
clinical features, early fall episodes and cognitive decline were
significant predictors of pneumonia (P = 0.001 and P<0.001,
respectively, log rank test). Cox regression analysis demonstrated that
early fall episodes (adjusted hazard ratio: 3.9, 95% confidence interval:
1.2–12.5, P = 0.03) and cognitive decline (adjusted hazard ratio: 5.2, 95%
confidence interval: 1.4–19.3, P = 0.02) independently predicted
pneumonia. By contrast, dysphagia was not associated with pneumonia (P =
0.2, log rank test). Conclusion: Initial development of pneumonia
indicates an unfavorable clinical course and predicts survival time (mean
survival time 2.3 years). Patients with early falls and cognitive decline
were at high risk of early development of pneumonia.