Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio / Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
Consejería de Salud y Bienestar Social de Andalucía. Seville, Spain.
Lancet Respir Med. 2014 Jan;2(1):54-62. doi: 10.1016/S2213-2600(13)70232-7. Epub 2013 Dec 6.
Findings from studies done over the past 20 years suggest that mortality from chronic obstructive pulmonary disease (COPD) is decreasing worldwide, but little information is available for trends in Europe. We aimed to describe COPD mortality trends by sex and calendar year for the period of 1994 to 2010.
We extracted data for COPD deaths between 1994 and 2010 in the 27 countries in the European Union (EU) from the statistical office of the EU (Eurostat), using the International Classification of Diseases 10 (ICD-10) codes J40-J44 and J47. We estimated age-standardised mortality rates (ASR), and analysed data using joinpoint regression, for women and men in the EU overall and by individual country for each year. We used the standard European population as the reference and present our findings as deaths per 100,000 person-years. We compared findings for each country with the EU average by calculating standardised rate ratios (SRR) and 95% CIs.
Between 1994 and 2010, there were 2,348,184 recorded COPD deaths in the EU. COPD mortality was higher in men than in women throughout the study period in all EU countries. In the EU overall, deaths per 100,000 population decreased in men almost linearly from 90·07 in 1994 to 61·33 in 2010, and in women from 26·99 in 1994 to 25·15 in 2010, representing a narrowing in gender gap over the study period. Several countries had a higher SRR mortality than the EU average-eg, Ireland, Hungary, and Belgium for men and Denmark, the UK, and the Netherlands for women. Our joinpoint regression analysis identified no statistically significant changes in the trend for the whole EU, but several countries had changing trends over the study period. In men, we recorded a 2·56% constant and statistically significant decrease in ASRs in the EU. Five countries had an increase in ASR. Overall, in women, we recorded a 0·76% statistically significant decrease in ASRs. 14 countries had an increase in ASR.
Our findings indicate a downward trend in COPD mortality in Europe between 1994 and 2010. The data also suggest a narrowing of the gap between COPD mortality in men and in women. The wide heterogeneity in mortality rates within European countries could serve as a reference to allow informed policy making.
None.
过去 20 年的研究结果表明，全球慢性阻塞性肺疾病（COPD）的死亡率正在下降，但欧洲的相关趋势信息较少。我们旨在描述 1994 年至 2010 年期间按性别和日历年度划分的 COPD 死亡率趋势。
我们从欧盟（EU）统计局提取了 1994 年至 2010 年间欧盟 27 个国家的 COPD 死亡数据，使用国际疾病分类第 10 版（ICD-10）J40-J44 和 J47 编码。我们按性别和年份计算了欧盟总体以及每个国家的年龄标准化死亡率（ASR），并使用连接点回归进行了分析。我们以标准欧洲人口为参照，以每 10 万人年的死亡人数表示结果。我们通过计算标准化率比（SRR）及其 95%置信区间，将每个国家的结果与欧盟平均值进行比较。
1994 年至 2010 年间，欧盟共记录了 234.8184 例 COPD 死亡。在整个研究期间，所有欧盟国家的 COPD 死亡率均高于女性。在欧盟总体中，男性的死亡率从 1994 年的 90.07 人/10 万降至 2010 年的 61.33 人/10 万，几乎呈线性下降，女性从 1994 年的 26.99 人/10 万降至 2010 年的 25.15 人/10 万，表明性别差距在研究期间有所缩小。一些国家的死亡率高于欧盟平均值，例如男性中的爱尔兰、匈牙利和比利时，以及女性中的丹麦、英国和荷兰。我们的连接点回归分析没有发现整个欧盟的趋势有统计学意义的变化，但一些国家在研究期间的趋势有所变化。在男性中，我们记录到欧盟的 ASR 呈 2.56%的恒定且具有统计学意义的下降。有 5 个国家的 ASR 上升。总体而言，在女性中，我们记录到 ASR 呈 0.76%的统计学意义下降。有 14 个国家的 ASR 上升。
我们的研究结果表明，1994 年至 2010 年间，欧洲的 COPD 死亡率呈下降趋势。数据还表明，男性和女性 COPD 死亡率之间的差距正在缩小。欧洲各国之间死亡率的高度异质性可以作为制定知情政策的参考。
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