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

P. K. Myint, K. R. Hawkins, A. B. Clark, R. N. Luben, N. J. Wareham, K-T. Khaw, A. M. Wilson

Research output: Contribution to journalArticle

4 Downloads (Pure)

Abstract

Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-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 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4-9·9] and 5·9 (95% CI 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 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9-30·1). Hospitalized 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
Volume144
Issue number4
Early online date24 Aug 2015
DOIs
Publication statusPublished - Mar 2016

Fingerprint

Pneumonia
Mortality
Neoplasms
Confidence Intervals
Blood Pressure
Waist-Hip Ratio
International Classification of Diseases
Proportional Hazards Models
Cause of Death
Cardiovascular Diseases
Asthma
Smoking
Prospective Studies
Exercise
Population

Keywords

  • pneumonia
  • respiratory mortality
  • long-term mortality
  • all-cause mortality
  • cardiovascular mortality

Cite this

Myint, P. K., Hawkins, K. R., Clark, A. B., Luben, R. N., Wareham, N. J., Khaw, K-T., & Wilson, A. M. (2016). Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort. Epidemiology and Infection, 144(4), 803-809. https://doi.org/10.1017/S0950268815001971

Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort. / Myint, P. K.; Hawkins, K. R.; Clark, A. B.; Luben, R. N.; Wareham, N. J.; Khaw, K-T.; Wilson, A. M.

In: Epidemiology and Infection, Vol. 144, No. 4, 03.2016, p. 803-809.

Research output: Contribution to journalArticle

Myint, PK, Hawkins, KR, Clark, AB, Luben, RN, Wareham, NJ, Khaw, K-T & Wilson, AM 2016, 'Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort', Epidemiology and Infection, vol. 144, no. 4, pp. 803-809. https://doi.org/10.1017/S0950268815001971
Myint, P. K. ; Hawkins, K. R. ; Clark, A. B. ; Luben, R. N. ; Wareham, N. J. ; Khaw, K-T. ; Wilson, A. M. / Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort. In: Epidemiology and Infection. 2016 ; Vol. 144, No. 4. pp. 803-809.
@article{0ddee604f0fe49278a5c10066d9c084b,
title = "Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort",
abstract = "Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-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 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95{\%} confidence interval (CI) 5·4-9·9] and 5·9 (95{\%} CI 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 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95{\%} CI 8·9-30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.",
keywords = "pneumonia, respiratory mortality, long-term mortality, all-cause mortality, cardiovascular mortality",
author = "Myint, {P. K.} and Hawkins, {K. R.} and Clark, {A. B.} and Luben, {R. N.} and Wareham, {N. J.} and K-T. Khaw and Wilson, {A. M.}",
note = "ACKNOWLEDGEMENTS The EPIC-Norfolk study is supported by programme grants from the Medical Research Council (G1000143) and Cancer Research UK (8257). The funders had no role in study design, analysis, and interpretation of the findings. We gratefully acknowledge the participants of the study and participating General Practitioners. We also thank our funders.",
year = "2016",
month = "3",
doi = "10.1017/S0950268815001971",
language = "English",
volume = "144",
pages = "803--809",
journal = "Epidemiology and Infection",
issn = "0950-2688",
publisher = "Cambridge University Press",
number = "4",

}

TY - JOUR

T1 - Long-term mortality of hospitalized pneumonia in the EPIC-Norfolk cohort

AU - Myint, P. K.

AU - Hawkins, K. R.

AU - Clark, A. B.

AU - Luben, R. N.

AU - Wareham, N. J.

AU - Khaw, K-T.

AU - Wilson, A. M.

N1 - ACKNOWLEDGEMENTS The EPIC-Norfolk study is supported by programme grants from the Medical Research Council (G1000143) and Cancer Research UK (8257). The funders had no role in study design, analysis, and interpretation of the findings. We gratefully acknowledge the participants of the study and participating General Practitioners. We also thank our funders.

PY - 2016/3

Y1 - 2016/3

N2 - Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-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 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4-9·9] and 5·9 (95% CI 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 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9-30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.

AB - Little is known about cause-specific long-term mortality beyond 30 days in pneumonia. We aimed to compare the mortality of patients with hospitalized pneumonia compared to age- and sex-matched controls beyond 30 days. Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Hospitalized pneumonia cases were identified from record linkage (ICD-10: J12-J18). For this study we excluded people with hospitalized pneumonia who died within 30 days. Each case identified was matched to four controls and followed up until the end June 2012 (total 15 074 person-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 2465 men and women (503 cases, 1962 controls) [mean age (s.d.) 64·5 (8·3) years] were included in the study. Between a 30-day to 1-year period, hazard ratios (HRs) of all-cause and cardiovascular mortality were 7·3 [95% confidence interval (CI) 5·4-9·9] and 5·9 (95% CI 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 1 year; respiratory cause of death being the most significant during that period (HR 16·4, 95% CI 8·9-30·1). Hospitalized pneumonia was associated with increased all-cause and specific-cause mortality beyond 30 days.

KW - pneumonia

KW - respiratory mortality

KW - long-term mortality

KW - all-cause mortality

KW - cardiovascular mortality

U2 - 10.1017/S0950268815001971

DO - 10.1017/S0950268815001971

M3 - Article

VL - 144

SP - 803

EP - 809

JO - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

IS - 4

ER -