Effect of weekend hospitalization on the duration of fasting in patients with aspiration pneumonia

BACKGROUND: Decreased swallowing function is an important risk factor for the development of aspiration pneumonia. A previous study reported that a long duration of fasting decreased swallowing function and increased mortality. The purpose of this study is to clarify the relationship between weekend hospitalization and fasting duration in older patients with aspiration pneumonia. METHODS: In this retrospective cohort study using hospital claims data and electronic medical record data between April 1, 2018, and March 31, 2020, 238 patients hospitalized for aspiration pneumonia were enrolled. Patients admitted from Monday to Friday were defined as the weekday admission group, and patients admitted on Saturday, Sunday, and holidays were defined as the weekend admission group. The primary endpoint was the duration of fasting. Multiple regression analysis was performed with age, gender, place of living, Functional Oral Intake Scale before admission, severity of pneumonia, and weekend admission as the independent variables. RESULTS: There were 41 patients in the weekend admission group and 103 patients in the weekday admission group. The baseline characteristics of the two groups were similar. There was a median difference in the fasting duration of 23.3 h; the fasting duration in the weekend admission group was significantly longer than the weekday admission group by 20.03 h (95% confidence interval: 2.81–37.25) in the multiple regression analysis. CONCLUSIONS: Weekend hospitalization was significantly associated with a longer fasting duration in patients hospitalized for aspiration pneumonia. There is a need to establish a system to enable early meal initiation for patients admitted on weekends.