Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Nov;17(6):194-202.
doi: 10.2188/jea.17.194.

Risk and protective factors related to mortality from pneumonia among middleaged and elderly community residents: the JACC Study

Yusuke Inoue  1 , Akio Koizumi, Yasuhiko Wada, Hiroyasu Iso, Yoshiyuki Watanabe, Chigusa Date, Akio Yamamoto, Shogo Kikuchi, Yutaka Inaba, Hideaki Toyoshima, Akiko Tamakoshi
Affiliations

Risk and protective factors related to mortality from pneumonia among middleaged and elderly community residents: the JACC Study

Yusuke Inoue et al. J Epidemiol. 2007 Nov.

Abstract

Background: There have been few systematic investigations into risk and protective factors for pneumonia related mortality for community residents. This study investigated these factors utilizing a large cohort study on Japanese community residents.

Methods: Subjects, 110,792 individuals (aged 40-79 years) enrolled in 1988-1990, were followed until death, or when they moved away from the surveyed communities, or the end of 2003. Pneumonia death was defined following 480-486 (International Classification of Diseases, 9th Revision) or J12-J18 (10th Revision). Age-adjusted and multivariate hazard ratios were calculated along with 95% confidence intervals using the Cox proportional hazards model.

Results: With 1,112,747 person-years of the study, a total of 1,246 persons died of pneumonia. We found history of blood transfusion (multivariate hazard ratio=2.0 [95% confidence interval: 1.7-2.4]) was a potent novel risk factor. Walking 0.5-1 hour/day (0.8 [0.6-1.0]), 1+ hour/day (0.7 [0.6-0.8]), and/or a history of pregnancy (0.6 [0.4-0.9]) were found to reduce pneumonia mortality. A large body mass index (BMI) (25+kg/m(2)) was a protective factor (0.7 [0.5-0.8]), while low BMI (<18) was confirmed as a risk one (2.1 [1.7-2.6]). Smoking was an important preventable risk factor (1.6 [1.3-1.9], population attributable risk proportion=14%), and its cessation reduced risk (0.7 [0.5-1.0]) to levels comparable to neversmokers (0.7 [0.5-1.0]).

Conclusions: The risk and protective factors ascertained here for pneumonia mortality among community residents, history of blood transfusion, large BMI, and walking habits, warrant further study. Smoking cessation may effectively reduce pneumonia mortality.

PubMed Disclaimer

References

    1. Almirall J, Bolidar I, Balanzo X, Gonzalez CA. Risk factors for community-acquired pneumonia in adults: a population-based case-control study. Eur Respir J 1999; 13: 349-55. 10.1183/09031936.99.13234999 - DOI - PubMed
    1. Thomsen RW, Hundborg HH, Lervang HH, Johnsen SP, Schonheyder HC, Sorensen HT. Risk of community-acquired pneumococcal bacteremia in patients with diabetes: a population-based case-control study. Diabetes Care 2004; 27: 1143-7. 10.2337/diacare.27.5.1143 - DOI - PubMed
    1. Riquelme R, Torres A, El-Ebinary M, de la Bellacasa JP, Estruch R, Mensa J, et al. . Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic factors. Am J Respir Crit Care Med 1996; 154: 1450-5. 10.1164/ajrccm.154.5.8912763 - DOI - PubMed
    1. Lipsky BA, Boyko EJ, Inui TS, Koepsell TD. Risk factors for acquiring pneumococcal infections. Arch Intern Med 1986; 146: 2179-85. 10.1001/archinte.1986.00360230105016 - DOI - PubMed
    1. Quagliarello V, Ginter S, Han L, Van Ness P, Allore H, Tinetti M.. Modifiable risk factors for nursing home-acquired pneumonia. Clin Infect Dis 2005; 40: 1-6. 10.1086/426023 - DOI - PubMed

Publication types