Altered mental status increases risk of aspiration pneumonia. Which is a contributing factor?

• A. Hypothyroidism
• B. Chronic kidney disease
• C. Alcohol use disorder
• D. Aortic dissection

Answer: (C)

Impaired airway protection from reduced consciousness or diminished swallowing is what raises the risk for aspiration pneumonia. When someone is intoxicated or otherwise cognitively slowed, the gag and cough reflexes don’t work as effectively, making it easier for secretions or vomitus to be aspirated into the lungs.

Alcohol use disorder fits this pattern because intoxication (and withdrawal states) causes sedation and poor coordination of swallowing, increasing the chance of aspirating oropharyngeal or gastric contents. The other options don’t directly provide the same risk: hypothyroidism can cause fatigue or cognitive issues but isn’t a classic driver of acute aspiration; chronic kidney disease can lead to encephalopathy in some cases but isn’t a specific risk factor for aspiration pneumonia; aortic dissection is a vascular emergency with no direct link to airway protection.