Department of Medical Informatics, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Respir Med. 2011 Dec;105(12):1872-84. doi: 10.1016/j.rmed.2011.06.012. Epub 2011 Aug 17.
Worldwide, COPD is a leading cause of chronic morbidity and mortality. Although its prevalence is already well documented, very few studies have measured its incidence. We therefore investigated the prevalence, incidence and lifetime risk of COPD in the general population. In a population-based study including subjects ≥ 40, with 12 months of history available in the Dutch IPCI database, we identified COPD cases by a two-step validation algorithm. Among 185,325 participants with 601,283 years of follow-up, 7308 subjects with COPD were identified, and 1713 had incident COPD. The overall IR of physician-diagnosed COPD was 2.92/1000PY (95%CI 2.78-3.06). The incidence of COPD was higher in men (3.54; 95%CI 3.33-3.77) than in women (2.34; 95%CI 2.17-2.52), and the overall baseline prevalence of COPD was 3.02% (95%CI 2.94-3.10). For people who had entered the study free of COPD at the age of 40, the risk of developing COPD within the next 40 years was 12.7% for men and 8.3% for women. In patients with very severe COPD, 26% died after 1 year of follow-up, whereas 2.8% died among the non-COPD subjects. In the general population in the Netherlands, three on 1000 subjects were diagnosed with COPD per year. The incidence increased rapidly with age and was higher in men than in women. One in eight men and one in 12 women, being COPD free at the age of 40, will develop COPD during their further life. Mortality rates differed substantially between COPD patients and non-COPD subjects of the same age, underlining the burden of this disease.
在全球范围内，COPD 是导致慢性发病率和死亡率的主要原因。尽管其患病率已有充分记录，但很少有研究测量其发病率。因此，我们调查了一般人群中 COPD 的患病率、发病率和终生风险。在一项基于人群的研究中，纳入了≥40 岁的受试者，在荷兰 IPCI 数据库中有 12 个月的病史，我们通过两步验证算法确定了 COPD 病例。在 185325 名参与者中，有 601283 人随访了 12 个月，其中 7308 名患有 COPD，1713 名患有新发 COPD。医生诊断的 COPD 总发病率为 2.92/1000PY（95%CI 2.78-3.06）。男性的 COPD 发病率（3.54；95%CI 3.33-3.77）高于女性（2.34；95%CI 2.17-2.52），总体基线 COPD 患病率为 3.02%（95%CI 2.94-3.10）。对于在 40 岁时无 COPD 进入研究的人来说，在接下来的 40 年内患 COPD 的风险为男性 12.7%，女性 8.3%。在极重度 COPD 患者中，26%的患者在随访 1 年后死亡，而非 COPD 患者的死亡率为 2.8%。在荷兰的一般人群中，每年每 1000 人中就有 3 人被诊断患有 COPD。发病率随年龄迅速增加，男性高于女性。在 40 岁时无 COPD 的男性中，有 1/8 会在以后的生活中患上 COPD；在 40 岁时无 COPD 的女性中，有 1/12 会在以后的生活中患上 COPD。COPD 患者和相同年龄的非 COPD 患者的死亡率差异很大，突出了这种疾病的负担。
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