Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.
Brotman Baty Institute for Precision Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
J Infect Dis. 2022 Aug 15;226(Suppl 2):S255-S266. doi: 10.1093/infdis/jiac187.
Death certificate data can improve our understanding of the mortality burden associated with respiratory syncytial virus (RSV) and influenza.
We used International Classification of Diseases, Tenth Revision codes listed on death certificates to characterize deaths from 1999 to 2018 as RSV, influenza, and unspecified bronchiolitis. We described the distribution of each cause of death by age, sex, race/ethnicity, place of death, and contributing causes of death.
Over the 20-year study period, RSV, bronchiolitis, and influenza were listed as the underlying causes of death on 932, 1046, and 52 293 death certificates, respectively. Children <1 year of age accounted for 39% of RSV and bronchiolitis deaths, while 72% of influenza deaths were in adults ≥65 years. Children <1 year were more likely to die outside of the hospital from RSV, bronchiolitis, or influenza compared to all causes (P < .01), and black infants had the highest mortality rate for all 3 causes. Most infants dying from RSV did not have a high-risk condition listed on the death certificate. Death certificates captured 20%-60% of estimated excess RSV-attributable mortality in infants and <1% in seniors.
Thorough reporting on death certificates is an important public health goal, especially as new therapeutics become available. Infants had higher odds of dying out of hospital from respiratory pathogens compared to other causes, and race/ethnicity alone did not explain this disparity.
死亡证明数据可以帮助我们更好地了解与呼吸道合胞病毒（RSV）和流感相关的死亡负担。
我们使用死亡证明上列出的国际疾病分类第十版代码，将 1999 年至 2018 年的死亡原因分别归类为 RSV、流感和未特指的细支气管炎。我们按年龄、性别、种族/族裔、死亡地点和主要死亡原因描述了每种死因的分布情况。
在 20 年的研究期间，RSV、细支气管炎和流感分别有 932、1046 和 52293 份死亡证明将其列为根本死因。<1 岁的儿童占 RSV 和细支气管炎死亡人数的 39%，而 72%的流感死亡发生在≥65 岁的成年人中。与所有原因相比，<1 岁的儿童因 RSV、细支气管炎或流感而在医院外死亡的可能性更高（P < .01），且所有 3 种疾病中黑人婴儿的死亡率最高。大多数死于 RSV 的婴儿在死亡证明上没有列出高危情况。死亡证明记录了估计的 RSV 相关婴儿超额死亡率的 20%-60%，而老年人中则不到 1%。
死亡证明的全面报告是一个重要的公共卫生目标，特别是随着新疗法的出现。与其他原因相比，婴儿因呼吸道病原体而在医院外死亡的几率更高，且种族/族裔并不能完全解释这一差异。
