Cooreman J, Thom T J, Higgins M W
Institut National de la Santé et de la Recherche Médicale, Le Vesinet, France.
Chest. 1990 Jan;97(1):213-9. doi: 10.1378/chest.97.1.213.
This article focuses on international similarities and differences in levels and trends of mortality for chronic obstructive pulmonary disease (COPD) and asthma in the US, Canada and France from 1969 to 1983. Comparisons have been made of national vital statistics data for age groups 55-64 years, 65-74 years and 75-84 years. From 1969 to 1978, under the 8th revision of the International Classification of Diseases (ICD), the COPD and asthma category included the codes 490-493 and, for the US and Canada, a special code 519.3. From 1979, under the 9th revision, COPD and asthma codes 490-493, 496 were in use in all three countries. The analyses of US, Canadian and French data show lower death rates for COPD and asthma in France. The ratio of male to female deaths from COPD increased with age in the US and Canada, but not in France. The proportion of COPD and asthma deaths attributed to bronchitis was higher in France. An increased use of code 496 (under 9th revision) was observed in the US and above all in Canada. In the three countries, death rates increased faster between 1979 and 1983 in women than in men and increases in women were steeper in the US and Canada than in France. Intercountry comparability is better for COPD mortality in the 9th revision than the 8th revision. Some differences observed between the three countries can be partly explained by coding practices and ICD revisions, but, allowing for differences in coding and classifying respiratory causes of death as well as ICD revisions, death rates are obviously higher in the US and Canada than in France. This suggests that the difference is real.
本文聚焦于1969年至1983年期间美国、加拿大和法国慢性阻塞性肺疾病（COPD）及哮喘的死亡率水平和趋势的国际异同。对55 - 64岁、65 - 74岁和75 - 84岁年龄组的国家生命统计数据进行了比较。1969年至1978年，根据《国际疾病分类》（ICD）第8次修订版，COPD和哮喘类别包括编码490 - 493，在美国和加拿大还有一个特殊编码519.3。从1979年起，根据第9次修订版，COPD和哮喘编码490 - 493、496在所有三个国家都开始使用。对美国、加拿大和法国数据的分析表明，法国的COPD和哮喘死亡率较低。在美国和加拿大，COPD男性死亡与女性死亡的比例随年龄增长而增加，但在法国并非如此。法国归因于支气管炎的COPD和哮喘死亡比例更高。在美国尤其是加拿大，观察到编码496（第9次修订版）的使用有所增加。在这三个国家，1979年至1983年期间女性死亡率的增长速度快于男性，且在美国和加拿大女性的增长幅度比法国更大。第9次修订版中COPD死亡率的国家间可比性比第8次修订版更好。三个国家之间观察到的一些差异部分可以通过编码实践和ICD修订来解释，但考虑到呼吸死亡原因编码和分类的差异以及ICD修订情况，美国和加拿大的死亡率明显高于法国。这表明这种差异是真实存在的。
