When assessing patients for the risk of aspiration pneumonia, key factors to evaluate include impaired swallowing or dysphagia, neurological disorders affecting consciousness or airway protection, and conditions causing reduced cough reflex or impaired gag reflex. These include stroke, Parkinson’s disease, dementia, and other neurodegenerative diseases. Additionally, patients with impaired consciousness due to sedation, alcohol intoxication, or anaesthesia are at increased risk. Other important risk factors are poor oral hygiene, gastro-oesophageal reflux disease (GORD), and the presence of feeding tubes, especially if not managed carefully. Frailty and advanced age also contribute to increased vulnerability. Identifying these factors is crucial for early intervention and prevention of aspiration pneumonia NICE CG191 Son et al. 2017.
These risk factors reflect the pathophysiology of aspiration pneumonia, where inhalation of oropharyngeal or gastric contents leads to lung infection. The UK guidelines emphasise the importance of recognising neurological impairment and swallowing dysfunction as primary contributors, while recent literature highlights the role of impaired airway protective reflexes and the impact of comorbidities such as GORD and poor oral hygiene in increasing risk Son et al. 2017 NICE CG191.