• Nastaran Eizadi-Mood, Mahmood Saghaei, Sam Alfred, Amir Hooshang Zargarzadeh, Chanh Huynh, Farzad Gheshlaghi, Ahmad Yaraghi, and Yousef Shadi Saad.
• Isfahan University of Medical Sciences, Isfahan, Iran. izadi@med.mui.ac.ir
• J Crit Care. 2009 Sep 1;24(3):470.e9-15.

PurposeThe purpose of the study was to assess the incidence of aspiration pneumonitis (AP) and its association with gag reflex and Glasgow Coma Score (GCS).Materials And MethodsIn a retrospective analysis study after prospective data collection, 155 poisoned patients with GCS less than or equal to 12 were evaluated. An assessment of GCS and the quality of gag reflex was made on arrival and recorded. Intubation status before gastrointestinal decontamination was noted. All patients were subsequently followed for developing of AP.ResultsThe incidence of AP was 15.5%, with significant variance among patients with respect to the gag reflex, GCS, and the performance of intubation. A logistic regression model for predicting AP contained the following predictors: GCS (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.30-0.62), intubation (OR, 0.07; 95% CI, 0.01-0.49), organophosphate ingestion (OR, 1.39; 95% CI, 0.96-2.01), and gastric evacuation (OR, 4.29; 95% CI, 0.94-9.51). In patients with reduced gag reflex, variations in GCS were associated with AP (OR, 0.43; 95% CI, 0.20-0.90), whereas in patients with absent gag reflex, age was the most important predictor of AP (OR, 2.67; 95% CI, 0.99-7.22).ConclusionsA reduced GCS and a nonintubated trachea are associated with an increased incidence of AP.

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