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The European Journal of Public Health Advance Access originally published online on June 23, 2009
The European Journal of Public Health 2009 19(5):521-526; doi:10.1093/eurpub/ckp081
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Infectious Diseases

Pneumonia mortality in a UK general practice population cohort

Puja R. Myles, Richard B. Hubbard, Jack E. Gibson, Zara Pogson, Christopher J. P. Smith and Tricia M. McKeever

Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG9 2AG, UK

Correspondence:Puja R. Myles, Room B28, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK, tel: +44-115-8231700, fax: +44-115-823 1946, e-mail: puja.myles{at}nottingham.ac.uk

Received February 2, 2009 , accepted May 26, 2009

Background: Pneumonia is a common diagnosis in general practice in the United Kingdom and yet there is little known about the short- and long-term prognosis of people with a diagnosis of pneumonia in general practice. We investigated the short- and long-term survival of people with pneumonia diagnosed in general practice as compared to the general population for all ages. Methods: This was a general population-based cohort study. Data was obtained from a comprehensive general practice database called The Health Improvement Network (THIN) database which has computerized medical records from 300 general practice surgeries in the United Kingdom. We used Cox regression for our analyses. Results: For pneumonia cases the 30-day mortality was 18.5% and the 3-year mortality was 30.8%. The equivalent figures for the general population controls were 0.4% and 10.3% respectively. The adjusted hazard ratio (HR) for all-cause mortality (for total follow-up time) in pneumonia cases vs. general population was 4.64 (95% CI 4.35–4.95). For the first 30 days the risk of mortality in cases was 46 times more (adj. HR 45.90, 95% CI 36.80–55.20). Even in the period of follow-up 91 days after diagnosis cases were almost 20% more likely to die compared to general population (adj. HR 1.19, 95% CI 1.08–1.31). Conclusion: People in general practice who have a diagnosis of pneumonia have a markedly increased mortality in the short-term but some increase in mortality persists during longer-term follow-up.

Keywords: pneumonia, epidemiology, mortality, general practice, primary care database


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