Long term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort

Phyo Kyaw Myint, Katie R. Hawkins, Allan B. Clark, Robert N. Luben, Nicholas J. Wareham, Kay-Tee Khaw, Andrew M. Wilson

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Little is known about the cause-specific long term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalised pneumonia compared to age-sex matched controls beyond 30-days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalised pneumonia cases were identified from record linkage (ICD 10 J12-J18). For this study we excluded people with hospitalised pneumonia who died within 30-days. Each case identified was matched for 4 controls and followed up till end June 2012 (total person year 15,074 years (mean 6.1 years, range 0.08– 15.2 years). Cox-regression models were constructed to examine the all-cause, respiratory and cardiovascular mortality using date of pneumonia onset as baseline with binary pneumonia status as exposure. A total of 2,465 men and women (503 cases and 1962 controls) (mean age 64.5, SD 8.3 years) were included in the study. Between a 30-day to one year period, HRs of all-cause and cardiovascular mortality were 7.3 (5.4-9.9) and 5.9 (3.5-9.7)respectively (with very few respiratory deaths within the same period) in cases compared to controls after adjusting for age, sex, asthma, smoking status, pack years, systolic and diastolic blood pressure, diabetes, physical activity, waist-to-hip ratio, prevalent cardiovascular and respiratory diseases. All outcomes assessed also showed increased risk of death in cases compared to controls after one year; respiratory cause of death being the most significant during that period (16.4;8.9-30.1). Hospitalised pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.
Original languageEnglish
Pages (from-to)803-809
Number of pages7
JournalEpidemiology and Infection
Issue number4
Early online date24 Aug 2015
Publication statusPublished - Mar 2016


  • Pneumonia
  • Longer term mortality
  • All cause mortality
  • Cardiovascular mortality
  • Respiratory mortality

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