Graudenz Gustavo Silveira, Carneiro Dominique Piacenti, Vieira Rodolfo de Paula
. Departamento de Ciências Médicas, Universidade Nove de Julho, São Paulo (SP) Brasil.
. Programa de Pós-Graduação em Gerenciamento Ambiental e Sustentabilidade, Universidade Nove de Julho, São Paulo (SP) Brasil.
J Bras Pneumol. 2017 Jan-Feb;43(1):24-31. doi: 10.1590/S1806-37562015000000253.
To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years.
Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups.
There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population.
Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate.
提供巴西两个年龄组（0 - 4岁和5 - 34岁）哮喘死亡率趋势的最新情况。
从巴西统一医疗系统信息技术部维护的死亡率数据库中获取1980 - 2014年期间国际疾病分类所定义的哮喘死亡率数据。为分析标准化哮喘死亡率的时间趋势，我们进行了一项生态时间序列研究，对0至4岁和5至34岁年龄组使用回归模型。
两个年龄组的哮喘死亡率均呈线性下降趋势，而总体人群呈现三阶多项式拟合。
尽管34岁及以下个体的哮喘死亡率呈持续线性下降，但0至4岁年龄组的下降速度更快。5至34岁年龄组的死亡率也呈线性下降，且在2004年吸入性糖皮质激素治疗更广泛应用后，下降速度加快。两个年龄组中哮喘死亡率的线性下降与巴西总体人群中观察到的非线性趋势形成对比。通过公共政策引入吸入性糖皮质激素来控制哮喘，同时5岁以上两个亚组的哮喘死亡率显著下降。较年轻年龄组中与哮喘相关死亡率下降的原因仍是一个有争议的问题。
