Zhou Zifang, Wang Lijun, Zhou Maigeng, Yin Peng
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
China CDC Wkly. 2024 Oct 25;6(43):1105-1110. doi: 10.46234/ccdcw2024.226.
China faces a growing burden of chronic obstructive pulmonary disease (COPD). Previous mortality estimations were primarily based on the underlying cause of death. This study analyzed COPD-associated death and its comorbidities using all COPD cases listed on the chain of events on death certificates.
A retrospective analysis of the National Mortality Surveillance System (NMSS) was conducted to estimate COPD-associated mortality from 2014 to 2021. Age-standardized mortality rates (ASMRs) were calculated stratified by sex, region, and residence. Joinpoint regression was used to estimate the average annual percentage change (AAPC) during the study period.
From 2014 to 2021, the ASMR of COPD decreased from 91.85 to 45.90 per 100,000 population. Significant but uneven decreases in COPD mortality were observed across gender [females: AAPC: -11.2%, 95% confidence interval (): -11.9 to -10.4%; males: AAPC: -8.0%, 95% : -9.2 to -6.8%], regions (eastern: AAPC: -10.7%, 95% : -11.5 to -9.9%; central: AAPC: -9.9%, 95% : -10.9 to -8.9%; western: AAPC: -7.7%, 95% : -10.6 to -4.7%), and residential areas (urban: AAPC: -10.9%, 95% : -12.3 to -9.5%; rural: AAPC: -8.3%, 95% : -9.1 to -7.4%). Other than COPD, cardiovascular diseases and respiratory conditions were the major underlying causes of death in COPD-associated mortality.
COPD is a significant comorbidity of other disorders in China. Although COPD-associated mortality substantially decreased from 2014 to 2021, the burden remained high in underdeveloped regions.
中国慢性阻塞性肺疾病（COPD）的负担日益加重。以往的死亡率估计主要基于死亡的根本原因。本研究使用死亡证明事件链上列出的所有COPD病例分析了COPD相关死亡及其合并症。
对国家死亡率监测系统（NMSS）进行回顾性分析，以估计2014年至2021年COPD相关死亡率。按性别、地区和居住地分层计算年龄标准化死亡率（ASMR）。采用Joinpoint回归估计研究期间的平均年度百分比变化（AAPC）。
2014年至2021年，COPD的ASMR从每10万人91.85例降至45.90例。在性别[女性：AAPC：-11.2%，95%置信区间（CI）：-11.9至-10.4%；男性：AAPC：-8.0%，95%CI：-9.2至-6.8%]、地区（东部：AAPC：-10.7%，95%CI：-11.5至-9.9%；中部：AAPC：-9.9%，95%CI：-10.9至-8.9%；西部：AAPC：-7.7%，95%CI：-10.6至-4.7%）和居住地区（城市：AAPC：-10.9%，95%CI：-12.3至-9.5%；农村：AAPC：-8.3%，95%CI：-9.1至-7.4%）中观察到COPD死亡率有显著但不均衡的下降。除COPD外，心血管疾病和呼吸系统疾病是COPD相关死亡的主要根本原因。
COPD是中国其他疾病的重要合并症。尽管2014年至2021年COPD相关死亡率大幅下降，但在欠发达地区负担仍然很高。
