北卡罗来纳州慢性阻塞性肺疾病的患病率、特征及影响

Pleasants Roy A, Herrick Harry, Liao Winston

Campbell University, College of Pharmacy and Health Sciences, Division of Pharmacy Practice, Leslie Campbell Ave., Buies Creek, NC 27506, USA.

N C Med J. 2013 Sep-Oct;74(5):376-83.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. We describe the prevalence, characteristics, and impact of COPD in North Carolina.

METHODS

We determined the prevalence of self-reported COPD and characteristics of affected persons using data from the 2009 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. We also determined the number of persons with COPD in nursing homes and adult care or family care homes. We drew conclusions about the impact of COPD from data regarding mortality, hospitalizations, emergency department visits, prednisone use, and health impairment.

RESULTS

The age-adjusted prevalence of COPD among BRFSS survey respondents was 5.6%, and about 10,000 adults in nursing homes, adult care homes, or family care homes had COPD; thus we estimate that nearly 408,000 adults in North Carolina had COPD in 2009. Rates of self-reported COPD were highest among elderly individuals, smokers, individuals with less education, and those with lower incomes. Mental and physical impairment were significantly worse in those with COPD, two-thirds of whom reported that dyspnea affected their quality of life. Prednisone use was reported by 27.4% of persons with COPD, 11.4% of respondents with COPD had been hospitalized for this condition within the preceding year, and COPD admissions accounted for 1.44% of all hospital charges. Asthma, heart disease, stroke, and diabetes mellitus were significantly more common in persons with COPD. In terms of mortality, COPD was the fourth leading cause of death (n = 4,324); 77% of COPD deaths were among persons who had no education beyond high school, and 53% of those who died were women. COPD was reported in 17.1% of deaths from all causes, 21% of deaths from asthma, 10.1% of deaths from lung cancer, and 6.7% of deaths from heart disease.

LIMITATIONS

These data are based on population and health care database estimates and are approximations.

CONCLUSION

COPD has substantial effects on the health of North Carolinians.

背景

慢性阻塞性肺疾病（COPD）是发病和死亡的主要原因。我们描述了北卡罗来纳州COPD的患病率、特征及影响。

方法

我们利用2009年北卡罗来纳州行为危险因素监测系统（BRFSS）调查的数据，确定了自我报告的COPD患病率及受影响人群的特征。我们还确定了疗养院、成人护理或家庭护理机构中患有COPD的人数。我们从关于死亡率、住院治疗、急诊就诊、泼尼松使用及健康损害的数据中得出关于COPD影响的结论。

结果

BRFSS调查受访者中COPD的年龄调整患病率为5.6%，疗养院、成人护理机构或家庭护理机构中约有10000名成年人患有COPD；因此我们估计2009年北卡罗来纳州近408000名成年人患有COPD。自我报告的COPD患病率在老年人、吸烟者、受教育程度较低者及收入较低者中最高。COPD患者的精神和身体损害明显更严重，其中三分之二的人报告呼吸困难影响了他们的生活质量。27.4%的COPD患者报告使用过泼尼松，11.4%的COPD受访者在过去一年因该病住院，COPD住院费用占所有住院费用的1.44%。哮喘、心脏病、中风和糖尿病在COPD患者中明显更常见。在死亡率方面，COPD是第四大主要死因（n = 4324）；77%的COPD死亡病例发生在高中以上无学历的人群中，53%的死亡者为女性。在所有死因中，17.1%的死亡报告患有COPD，哮喘死亡者中有21%，肺癌死亡者中有10.1%，心脏病死亡者中有6.7%。