LONG-TERM PREDICTORS OF DEATH FROM PNEUMONIA IN A GENERAL JAPANESE POPULATION

PURPOSE: Pneumonia is a major cause of mortality among adults. This study aims to investigate predictors of long-term mortality from pneumonia in a longitudinal study of a representative sample from the general Japanese population. METHODS: This is a prospective observational study. Data are from the National Intergrated Project for Prospective Observation of Noncommunicable Disease and Its Trend in the Aged 1980-2009 (NIPPON DATA80). 9,462 participants aged ≥30 years from randomly selected areas in Japan were followed for up to 29 years. Risk factors included age, sex, body mass index, systolic blood pressure, diabetes, serum albumin, total cholesterol, smoking, alcohol intake, and history of stroke. Effects of risk factors on death from pneumonia were estimated using Cox’s proportional hazards models. RESULTS: During the 29-year period of follow-up, 326 deaths from pneumonia were observed. The multivariable-adjusted hazard ratio (HR) for pneumonia death was 5.07 (95% Confidence interval [CI] 4.42 to 5.83) per 10-year increase in age and 0.76 (95% CI 0.66 to 86) For, per a standard deviation (3 g/L)increase in serum albumin. The HR comparing women to men was 0.54 (95% CI 0.39 to 0.75). The HR of diabetes was 1.56 (95% CI 1.11 to 2.20). The HR comparing current smokers with never smokers was 1.38 (95% CI 1.01 to 1.88). CONCLUSIONS: In this long-term prospective study of a general Japanese population sample, age, male sex, diabetes, low serum albumin, and current smoker were associated with increased risks of death due to pneumonia. CLINICAL IMPLICATIONS: Diabetic subjects may have increased susceptibility to pneumonia for several reasons.