期刊
RESPIRATORY MEDICINE
卷 186, 期 -, 页码 -出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.rmed.2021.106518
关键词
Epidemiology; Chronic obstructive pulmonary disease; Mortality; Risk factor; Physician diagnosis
资金
- Swedish Heart and Lung foundation
- Umea university Research grants
- Swedish Association for Respiratory Medicine
- VISARE NORR Fund Northern Country Councils Regional Federation
- County Council of Norrbotten
This study found that COPD as a cause of death is often underestimated, with only 57.1% of death certificates mentioning it even in individuals with severe disease. Smoking, physician-diagnosed COPD, and male gender were independently associated with COPD as a cause of death.
Background: In 2019, WHO estimated COPD to be the third leading cause of death in the world. However, COPD is probably underestimated as cause of death due to the well-known under-diagnosis. Aim: To evaluate the proportion of and factors associated with COPD recorded as cause of death in a long-term follow-up of a population-based COPD cohort. Methods: The study population includes all individuals (n = 551) with COPD defined as chronic airway obstruction (post-bronchodilator FEV1/FVC<0.70) + respiratory symptoms identified after re-examinations of four population-based cohorts. Mortality and underlying or contributing cause of death following ICD-10 classification were collected from the Swedish National Board of Health and Welfares register from date of examination in 2002-04 until 2016. Results: The study sample consisted of 32.3% GOLD 1, 55.9% GOLD 2, and 11.8% GOLD 3-4. The mean follow-up time was 10.3 (SD3.77) years and the cumulative mortality 45.0%. COPD (ICD-10 J43-J44) was recorded on 28.2% (n = 70) of the death certificates (11.1%, 25.7% and 57.1% by GOLD stage), whereof n = 35 had COPD recorded as underlying and n = 35 as contributing cause of death. To have COPD recorded as cause of death was independently associated with ex- and current smoking and a self-reported physician diagnosis of COPD, while male sex, overweight/obesity and higher FEV1% of predicted associated with the absence. Conclusions: COPD was largely underreported cause of death. Even among those with severe/very severe disease, COPD was only mentioned on 57.1% of the death certificates.
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