Sullivan Jamie, Pravosud Vira, Mannino David M, Siegel Keith, Choate Radmila, Sullivan Tracie
COPD Foundation, Washington, DC.
contributed equally to this report.
Chronic Obstr Pulm Dis. 2018 Oct 12;5(4):324-333. doi: 10.15326/jcopdf.5.4.2018.0157.
Chronic obstructive pulmonary disease (COPD) remains a leading cause of disability and death in the United States. The "COPD in the United States" project gathered data about the impact of COPD to highlight variability across states and provide a single point of access to data for state decision makers, the public health community and advocates. This report provides a summary of COPD-related morbidity and mortality in the United States and individual states during 2014-2015 (some metrics contain data from other years). We used data from multiple sources ( the Behavioral Risk Factor Surveillance System [BRFSS], the Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research online database, the CDC's chronic disease indicators data, Centers from Medicare and Medicaid Services Chronic Conditions Data Warehouse, Medical Expenditures Panel Survey and the American Association of Cardiovascular and Pulmonary Rehabilitation Pulmonary Rehabilitation Directory) to estimate 10 national and state-specific COPD metrics (prevalence, hospitalizations and emergency department visits, 30-day hospital readmissions, mortality, vaccinations, smoking prevalence, per capita medical cost, and the number of COPD patients per a pulmonary rehabilitation program) and to calculate average score across the 10 metrics. Additionally, we used BRFSS data to calculate the prevalence of common comorbid diseases among people who also report having a diagnosis of COPD. During 2014-2015, 5.9% of adults (more than 15.9 million) reported having been told by their health care professional that they had COPD. The age-adjusted prevalence ranged from 3.7% for Puerto Rico and Hawaii, to 12% for West Virginia. The average score, 1 being best and 5 being worst, of the overall COPD burden based on the 10 key metrics ranged from 1.5 for Puerto Rico and Utah to 4.6 for West Virginia. The level of COPD morbidity and mortality is severe throughout the United States. There is considerable variability in COPD metrics by state. These differences may be useful in identifying and addressing policy gaps in the public health approach to COPD and in implementing the COPD National Action Plan.
慢性阻塞性肺疾病（COPD）在美国仍然是导致残疾和死亡的主要原因。“美国的慢性阻塞性肺疾病”项目收集了有关慢性阻塞性肺疾病影响的数据，以突出各州之间的差异，并为州决策者、公共卫生界和倡导者提供单一的数据访问点。本报告总结了2014 - 2015年期间美国及各州与慢性阻塞性肺疾病相关的发病率和死亡率（部分指标包含其他年份的数据）。我们使用了多个来源的数据（行为风险因素监测系统[BRFSS]、疾病控制和预防中心（CDC）的广泛在线流行病学研究在线数据库、CDC的慢性病指标数据、医疗保险和医疗补助服务中心慢性病数据仓库、医疗支出小组调查以及美国心血管和肺康复协会肺康复名录）来估算10项全国性和各州特定的慢性阻塞性肺疾病指标（患病率、住院率和急诊就诊率、30天内再住院率、死亡率、疫苗接种率、吸烟率、人均医疗费用以及每个肺康复项目的慢性阻塞性肺疾病患者数量），并计算这10项指标的平均得分。此外，我们使用BRFSS数据计算了那些报告被诊断患有慢性阻塞性肺疾病的人群中常见合并症的患病率。在2014 - 2015年期间，5.9%的成年人（超过1590万）报告其医疗保健专业人员告知他们患有慢性阻塞性肺疾病。年龄调整后的患病率从波多黎各和夏威夷的3.7%到西弗吉尼亚州的12%不等。基于10项关键指标的慢性阻塞性肺疾病总体负担平均得分（1分为最佳，5分为最差）从波多黎各和犹他州的1.5到西弗吉尼亚州的4.6不等。在美国，慢性阻塞性肺疾病的发病率和死亡率水平很高。各州的慢性阻塞性肺疾病指标存在相当大的差异。这些差异可能有助于识别和解决公共卫生应对慢性阻塞性肺疾病方法中的政策差距，以及实施慢性阻塞性肺疾病国家行动计划。
