Allergy Department, Hospital Universitario Virgen Macarena, Seville, Spain.
Medicine Department, University of Seville, Seville, Spain.
J Investig Allergol Clin Immunol. 2023 Apr 18;33(2):119-125. doi: 10.18176/jiaci.0771. Epub 2021 Dec 13.
Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches.
Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed.
Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years.
Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends.
先前的研究表明，近年来西班牙的哮喘死亡率一直在下降。然而，这种趋势在不同年龄组之间并不均匀。目的：分析 40 年来哮喘死亡率的变化趋势，重点关注与新治疗方法发展相关的变化。
从国家统计局收集死亡记录和年中人口数据。使用直接法，计算了总人口以及每个性别和年龄组的年龄标准化死亡率。使用 Joinpoint 回归分析确定死亡率趋势的显著变化。还分析了年龄、时期和队列的独立影响以及因哮喘而丧失的潜在寿命年数。
西班牙的哮喘死亡率从研究的第一个五年期（1980-1984 年）到最后一个五年期（2015-2019 年），从每 10 万人 7.38 例下降到 2.03 例，在整个人群中。男性下降更为明显，从每 10 万人 10.37 例下降到 0.91 例，而女性从每 10 万人 5.53 例下降到 2.77 例。所有年龄组的死亡率都有所下降。在过去的 3 年中，>64 岁患者的死亡率趋于稳定，但 35-64 岁患者的死亡率有所增加。<35 岁患者的死亡率自 20 世纪 90 年代以来一直在迅速下降。
哮喘死亡率从 1980 年开始下降。年轻队列从 20 世纪 90 年代开始出现下降趋势，证实了之前的趋势。哮喘诊断的改善和新疗法的发展可能是观察到的变化的原因。需要密切监测哮喘死亡率以确认这些趋势。
