Division of Pulmonary and Critical Care, Howard University Hospital, Washington, DC.
Division of Pulmonary and Critical Care, Howard University Hospital, Washington, DC.
Ann Allergy Asthma Immunol. 2018 Jun;120(6):614-619. doi: 10.1016/j.anai.2018.03.005. Epub 2018 Mar 13.
Asthma mortality based on the underlying cause of death (UCOD) underestimates disease burden.
To analyze asthma mortality in the United States from 1999 to 2015 and the pattern of reporting of asthma and its comorbidities in death certificates, using multiple cause of death (MCOD) records.
All 156,517 death certificates with any mention of asthma were analyzed for 1999 to 2015. Asthma was defined by International Classification of Diseases, 10th Revision code J45 based on the UCOD or MCOD. Annual age-adjusted asthma death rates were computed according to age, sex, and race/ethnicity. The 6,304 MCOD coded status asthmaticus cases (J46) were also examined.
From 1999 to 2015 a total of 59,067 deaths with a UCOD of asthma occurred; 37,832 deaths occurred in females and 21,235 in males (female-male ratio = 1.78). A total of 156,517 deaths with MCOD of asthma occurred; 101,371 deaths occurred in females and 55,146 in males (female-male ratio = 1.83). Hence, 37.7% of deaths with any mention of asthma had asthma as the UCOD (37.3% in females and 38.45% in males). Of these deaths, 41.7% occurred in non-Hispanic blacks and 36% in non-Hispanic whites. Between 1999 and 2015, age-adjusted MCOD death rates changed as follows: 38.1% in Hispanic white females, 34.1% in non-Hispanic black females, 15.1% in non-Hispanic white females, 28.5% in Hispanic white males, 21.3% in non-Hispanic black males, and 25.0% in non-Hispanic white males. Non-Hispanic black females and males had the highest MCOD and UCOD rates throughout the period.
Among deaths with any mention of asthma, asthma was chosen as the UCOD most often in non-Hispanic black males and least often in non-Hispanic white females. Age-adjusted MCOD rates decreased most in non-Hispanic white males and least in non-Hispanic white females.
基于根本死因（UCOD）的哮喘死亡率低估了疾病负担。
分析 1999 年至 2015 年美国的哮喘死亡率，并利用多死因（MCOD）记录分析死亡证明中哮喘及其合并症的报告模式。
分析了 1999 年至 2015 年所有提及哮喘的 156517 份死亡证明。根据 UCOD 或 MCOD，采用国际疾病分类，第 10 版 J45 代码定义哮喘。根据年龄、性别和种族/民族计算每年年龄调整的哮喘死亡率。还检查了 6304 例 MCOD 编码的哮喘持续状态病例（J46）。
1999 年至 2015 年，共有 59067 例 UCOD 为哮喘的死亡；37832 例死亡发生在女性，21235 例死亡发生在男性（女性与男性之比为 1.78）。共有 156517 例 MCOD 编码的哮喘死亡；101371 例死亡发生在女性，55146 例死亡发生在男性（女性与男性之比为 1.83）。因此，37.7%有任何哮喘提及的死亡有哮喘作为 UCOD（女性为 37.3%，男性为 38.45%）。在这些死亡中，41.7%发生在非西班牙裔黑人中，36%发生在非西班牙裔白人中。1999 年至 2015 年间，年龄调整后的 MCOD 死亡率变化如下：西班牙裔白人女性 38.1%，非西班牙裔黑人女性 34.1%，非西班牙裔白人女性 15.1%，西班牙裔白人男性 28.5%，非西班牙裔黑人男性 21.3%，非西班牙裔白人男性 25.0%。整个时期，非西班牙裔黑人女性和男性的 MCOD 和 UCOD 率最高。
在任何有哮喘提及的死亡中，非西班牙裔黑人男性最常选择哮喘作为 UCOD，而非西班牙裔白人女性则最不常选择。年龄调整后的 MCOD 率在非西班牙裔白人男性中下降最多，在非西班牙裔白人女性中下降最少。
