Fatores de risco associados a pneumonia em pacientes adultos e idosos – revisão de escopo

Abstract

Introduction: This review addresses the risk factors for aspiration pneumonia in adults and the elderly, highlighting its high prevalence and the need for clear resolutions for prevention and effective management. Early identification of these often unclear factors is crucial. Understanding and delimiting these elements becomes essential to promote effective prevention and intervention practices in pathology. Objective: Map through a scoping review, the risk factors associated to aspiration pneumonia in adult and elderly patients. Method: Scoping review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science, and grey literature databases were systematically searched. The acronym 'PCCS' was used to consider the eligibility of studies for this review, representing: P = Population (≥18 years old), C = Concept (risk factors), C = Context (aspiration pneumonia), S = Studies (observational, interventional, cross-sectional studies, randomized, non-randomized and pseudo-randomized clinical studies). There were no restrictions regarding gender, ethnicity of individuals, language of studies and date of publication. Results: A total of 2,190 articles were obtained. After removing duplicate articles, 1,696 references were maintained. Subsequently, after applying the eligibility criteria, 1,585 studies were excluded, resulting in 111. A search was carried out in the gray literature and in the reference list of articles, thus totaling 3.183, 1 of them was seelected for a completed reading. After reading, 56 articles were excluded, resulting in 56 included studies. The risk factors associated with aspiration pneumonia in adult and elderly patients were investigated, totaling 132 elements cited. Some studies took a comprehensive approach by listing and analyzing multiple factors simultaneously, while others focused on specific aspects in their analyses. Final Considerations: Positive levels of scientific evidence related to aspiration pneumonia were identified. The risks include aspects such as dysphagia, aspiration, dietary modalities, neurological conditions, malnutrition, dehydration, changes in body mass index, skeletal mass index, mobility and dependence on activities. Furthermore, hospital institutionalization, including length of stay, endotracheal intubation and mechanical ventilation, is also associated. Mapping and analyzing these factors are essential for understanding and managing aspiration pneumonia, contributing significantly to the advancement of knowledge about this clinical condition.