Risk and Protective Factors Related to Mortality from Pneumonia among Middle-aged and Elderly Community Residents : The JACC Study

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概要

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• 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/m2) 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.J Epidemiol 2007; 17: 194-202.

• 日本疫学会の論文
• 2007-11-01

著者

• WATANABE Yoshiyuki

  Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medici

• ISO Hiroyasu

  Department of Public Health Medicine, Doctoral Program in Social and Environmental Medicine, Graduat

• DATE Chigusa

  Department of Nutrition and Food Science, Faculty of Human Environmental Science, Mukogawa Women's U

• Ito Yoshinori

  札幌医科大学 医学部公衆衛生学

• TOYOSHIMA Hideaki

  Department of Public Health/Health Information Dynamics, Field of Social Life Science, Program in He

• INOUE Yusuke

  Department of Radiology, Institute of Medical Sciences, University of Tokyo

• Iso Hiroyasu

  Osaka Univ. Osaka Jpn

• Ito Yoshinori

  Department Of Preventive Medicine/biostatistics And Medical Decision Making Nagoya University Gradua

• Tamakoshi Akiko

  Department Of Health Science Shiga University Of Medical Science

• INABA Yutaka

  Juntendo University School of Medicine

• Kikuchi S

  Aichi Medical Univ. Aichi Jpn

• Kikuchi Shogo

  愛知医科大学 医学部公衆衛生学講座

• Kikuchi Shogo

  Department Of Public Health Aichi Medical University School Of Medicine

• Kikuchi S

  Juntendo Univ. School Of Medicine Jpn

• YAMAMOTO Akio

  Department of Applied Chemistry, Graduate School of Science and Engineering, Waseda University

• Inaba Yutaka

  Juntendo Univ. Tokyo Jpn

• Inaba Yutaka

  Department Of Neurosurgery School Of Medicine Tokyo Medical:dental University

• Inaba Yutaka

  愛知医科大学 公衆衛生学

• Inaba Yutaka

  Department Of Epidemiology And Environmental Health Juntendo University School Of Medicine

• Takahashi H

  Department Of Public Health/health Information Dynamics Nagoya University Graduate School Of Medicin

• Toyoshima Hideaki

  名古屋大学 医学系研究科医学ネットワーク管理学

• Toyoshima Hideaki

  Department Of Medical Cardiology National Cardiovascular Center

• Toyoshima Hideaki

  愛知教育大学

• Tamakoshi Akiko

  京都府立医科大学 地域保健医療疫学

• Tamakoshi Akiko

  Department Of Epidemiology National Institute For Longevity Sciences

• Watanabe Y

  Kyoto Prefectural Univ. Medicine Kyoto Jpn

• Inaba Y

  Juntendo Univ. School Of Medicine

• Ishida Yoshiko

  Department Of Preventive Medicine-biostatistics And Medical Decision Making Nagoya University Gradua

• Toyoshima H

  Department Of Public Health/health Information Dynamics Nagoya University Graduate School Of Medicin

• Aoki Kunio

  Department Of Health And Environmental Sciences Kyoto University Graduate School Of Medicine

• Koizumi Akio

  Department Of Hygiene Yamaguchi University School Of Medicinemedicine

• Inaba Y

  Department Of Physics University Of Tokyo

• WADA Yasuhiko

  Department of Clinical Informatics, Kansai Rosai Hospital

• TAMAKOSHI Akiko

  Division of Clinical Trials, National Center for Geriatrics and Gerontology

• Inoue Yusuke

  Department Of Radiology Institute Of Medical Science University Of Tokyo

• Tamakoshi Akiko

  Division Of Clinical Trials National Center For Geriatrics And Gerontology

• Wada Yasuhiro

  Department Of Hygiene Akita University School Of Medicine

• Date Chigusa

  Dep. Of Food Sci. And Nutrition Fac. Of Human Life And Environment Nara Women's Univ.

• Date Chigusa

  Department Of Food Science And Nutrition Faculty Of Human Life And Environment Nara Women's Uni

• WADA Yasuhiko

  Hyogo College of Medicine

• Koizumi Akio

  Department Of Health And Environmental Science School Of Public Health Kyoto University

• Yamamoto Akio

  Infectious Diseases Division Hyogo Prefectural Institute Of Public Health And Environmental Sciences

• Inaba Y

  Department Of Epidemiology And Environmental Health Juntendo University School Of Medicine

• Kikuchi Shogo

  Department Of Epidemiology And Environmental Health Juntendo University School Of Medicine

• Takei Hiroyuki

  Second Department Of Surgery

• Aoki Kunio

  Program In Radiological And Medical Laboratory Sciences Nagoya University Graduate School Of Medicin

• Takei Hiroyuki

  Division Of Breast Surgery Saitama Cancer Center

• Watanabe Yoshiyuki

  Department Of Biotechnology And Chemistry School Of Engineering Kinki University

• Wada Yasuhiko

  Department Of Clinical Informatics Kansai Rosai Hospital

• Iso Hiroyasu

  Department Of Internal Medicine Division Of Nephrology And Rheumatology Aichi Medical University Sch

• Kimura Asami

  Dep. Of Public Health School Of Health Sciences Fujita Health Univ.

• Inaba Yutaka

  Department Of Health And Environmental Sciences Graduate School Of Medicine Kyoto University

• Date Chigusa

  Department Of Food Science And Nutrition Faculty Of Human Life And Environment Nara Women's Uni

• Inoue Yusuke

  Department Of Biomedical Engineering Graduate School Of Medicine The University Of Tokyo

• Inaba Yutaka

  Department Of Epidemiology And Enivironmental Health Juntendo University School Of Medicine

• Wada Yasuhiko

  Department Of Civil And Environmental Engineering

• Ito Yoshinori

  Department Of Preventive Medicine - Biostatistics And Medical Decision Making Nagoya University Grad

• Watanabe Yoshiyuki

  Department Of Epidemiology For Community Health And Medicine Kyoto Prefectural University Of Medicin

• Ito Yoshinori

  Department Of Preventive Medicine/biostatistics And Medical Decision Making Nagoya University Gradua

• Inoue Yusuke

  Department Of Health And Environmental Sciences Graduate School Of Medicine Kyoto University

• Yamamoto Akio

  Department Of Applied Chemistry Graduate School Of Science And Engineering And Advanced Research Cen

• INABA Yutaka

  Department of Physics, University of Tokyo

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