TUESDAY, April 13, 2004 (HealthDayNews) -- If you're over 40 and have been hospitalized for pneumonia, you may be at greater risk of dying within the two to three years after you're sent home -- even if you have no other known life-limiting health conditions, researchers have found.

Advancing age is one of several risk factors linked to a greater-than-expected death rate after hospitalization for pneumonia, according to a report in the April issue of the American Journal of Respiratory and Critical Care Medicine.

People 41 to 60 years old who had no previous illness were particularly vulnerable, the study found. That group's mortality rate was roughly six times greater than expected, according to Dr. Grant Waterer, a senior lecturer in medicine at the University of Western Australia and lead author of the study.

Pneumonia victims aged 61 to 80 with no other observed illnesses died at roughly twice the predicted rate of death for their age group.

Younger adults, ages 18 to 40, were at no increased risk of death after discharge, the study found.

"The message is that if you are young -- under 40 -- an episode of pneumonia is just bad luck," Waterer said. "If you are over 40, it may be an indication that all is not well, and your physician needs to look closely to see if there are any underlying illnesses that may not have been previously recognized," he cautioned.

Pneumonia was the immediate cause of 3.9 million deaths worldwide in 2002 and is responsible for more than 1 million hospitalizations in the United States each year, Dr. Scott Dowell, of the U.S. Centers for Disease Control and Prevention's International Emerging Infections Program, noted in an accompanying editorial in the journal.

"Considering the importance of pneumonia, it is remarkable how little is known about what happened to patients after they recover," Dowell observed.

Waterer and colleagues were mainly interested in showing whether pneumonia cuts longer-term survival in otherwise healthy patients. Their study involved patients with community-acquired pneumonia who were admitted to Methodist Healthcare Memphis Hospitals in Tennessee and survived discharge.

Investigators were able to determine the survival status of 366 patients, or 97 percent of patients in the study, over an average of three years after discharge. One hundred twenty-five of them -- or more than a third -- died after discharge.

Other health conditions -- especially heart disease and stroke, an altered mental state, anemia, and poorly controlled diabetes -- also were shown to be predictors of mortality after discharge for pneumonia.

The new findings add to a growing body of evidence indicating that pneumonia patients can expect a modestly to substantially increased death rate up to four years after hospitalization, Dowell noted.

Given that risk, Dowell suggests that patients and their families need to remain vigilant and pursue preventive health measures. For example, he said, "The prognosis for modern-day patients who recover from a first bout of pneumonia may be substantially improved by offering an effective smoking cessation program, influenza vaccine, and pneumococcal vaccine."

All physicians should include these preventive measures in their standing discharge orders for patients who have recovered from pneumonia, he added.

More information

Learn more about pneumonia from the American Lung Association or the National Library of Medicine.

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