Door-to-Oral Time Under 24 Hours Tied to Shorter LOS in Aspiration Pneumonia

Door-to-oral time (D2O) within 24 hours is associated with shorter length of hospitalization among patients with aspiration pneumonia (AP), according to study results published in Clinical Nutrition.

Researchers conducted a cohort study that comprised 398 patients aged 65 years or older with AP who were hospitalized between April 2015 and September 2020. The researchers classified D2O as early (first oral intake within 24 hours), middle (between 24 and 48 hours), or late (48 hours or more). They assessed length of stay, discharge with oral intake via regression analysis, and days between first oral intake and discharge via general linear models with estimation of variance.

Among those with AP, 35.7% (n=142) were in the D2O group, 27.9% (n=111) were in the middle D2O group, and 36.4% (n=145) were in the late D2O group. Early D2O was not significantly associated with a higher likelihood of discharge with oral intake compared with late D2O (odds ratio [OR] 1.09; 95% CI, 0.50-2.38; P =.834). However, the early D2O group experienced a comparatively shorter length of stay (adjusted length difference, -7.14; 95% CI, -10.80 to -3.42; P <.001), but not with shorter time between first oral intake and hospital discharge (adjusted length difference -3.34 days; 95% CI, -6.91 to 0.24; P =.067).

Limitations of the study include insufficient sample size, potentially inadequate study power, unknown accuracy with regard to documentation on oral intake, and potential lack of generalizability.

The study authors conclude, “D2O within 24 [hours] was not associated with discharge with oral intake or the number of days from first oral intake to discharge. However, it was associated with a shorter length of stay.” They indicate that additional research is necessary to assess “the appropriate timing of oral intake initiation in patients with AP.“