Louisiana raised its Hurricane Katrina death toll by 281 Friday to 1,577 after including more out-of-state evacuees whose deaths were deemed related to the storm or its grueling aftermath.

The Louisiana Department of Health and Hospitals decided that if residents' deaths were hastened by the stress and trauma associated with relocating — or even an accidental injury during travel — those deaths should be counted in the toll.

"Katrina was a tragedy like no other, and the human toll of the tragedy extends further than our traditional definition of a storm-related death," said Dr. Louis Cataldie, medical incident commander for Louisiana.

Louisiana officials asked other states to classify evacuees' deaths as storm-related if they occurred between Aug. 27 — two days before the storm hit — and Oct. 1 and met several general requirements.

During that period, 480 evacuees died in 30 states — mostly Texas, Mississippi and Alabama — of causes found to be related to Katrina. Some of those deaths were reported previously; the state's toll is up 281 from the last report, in February.

Health officials said much of what Katrina evacuees endured could have had lingering health effects: suffering in hot rooms when power had been knocked out, being stranded for days awaiting rescue, getting stuck in traffic during an hours-long evacuation and the stress of personal losses and the widespread devastation.

"Admittedly it is arbitrary, but (Cataldie's) belief was if someone already has an illness, is sick and institutionalized, the trauma involved in being relocated could hasten somebody's death," health department spokesman Bob Johannessen said.

If someone died in an auto accident while relocating, that too would be counted as Katrina-related. But if the accident occurred after new residence had been taken up, it would not be counted, Johannessen said.

Of the deaths reported out of state, 223 occurred among those who had fled to Texas. Mississippi has reported 63, Alabama 48, Florida 30, Tennessee 24 and Arkansas 20. Twenty-four other states, from Rhode Island to Montana, and the District of Columbia also reported at least one Katrina-related death.

The toll could be lowered if Louisiana officials disagree with other states' conclusions when they review evacuees' death certificates, Johannessen said.