Changing causes of death for patients with chronic respiratory disease in England, 2005-2015.
asthma epidemiology
bronchiectasis
clinical epidemiology
copd epidemiology
Journal
Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
21
08
2018
revised:
19
12
2018
accepted:
24
12
2018
pubmed:
31
1
2019
medline:
5
11
2019
entrez:
31
1
2019
Statut:
ppublish
Résumé
Chronic respiratory diseases (CRD) are common, are increasing in prevalence, and cause significant morbidity and mortality worldwide. However, we have limited knowledge on causes of death of patients with CRD in the general population. We evaluated mortality rates and causes of death over time in patients with CRD. We used linked primary care and mortality data to determine mortality rates and the most common causes of death in people with CRD (including asthma, bronchiectasis, COPD and interstitial lung diseases (ILD)) during 2005-2015 in England. We identified 558 888 patients with CRD (451 830 asthma, 137 709 COPD, 19 374 bronchiectasis, 10 745 ILD). The age-standardised mortality rate of patients with CRD was 1607 per 100 000 persons (asthma=856, COPD=1503, ILD=2609, bronchiectasis=1463). CRD mortality was overall 54% higher than the general population. A third of patients with CRD died from respiratory-related causes. Respiratory-related mortality was constant, while cardiovascular-related mortality decreased significantly over time. COPD accounted for the majority of respiratory-related deaths (66% overall) in all patient groups except ILD. Patients with CRD continue to experience substantial morbidity and mortality due to respiratory diseases. Disease-modifying intervention strategies are needed to improve outcomes for patients with CRD.
Sections du résumé
BACKGROUND
Chronic respiratory diseases (CRD) are common, are increasing in prevalence, and cause significant morbidity and mortality worldwide. However, we have limited knowledge on causes of death of patients with CRD in the general population.
OBJECTIVE
We evaluated mortality rates and causes of death over time in patients with CRD.
METHODS
We used linked primary care and mortality data to determine mortality rates and the most common causes of death in people with CRD (including asthma, bronchiectasis, COPD and interstitial lung diseases (ILD)) during 2005-2015 in England.
RESULTS
We identified 558 888 patients with CRD (451 830 asthma, 137 709 COPD, 19 374 bronchiectasis, 10 745 ILD). The age-standardised mortality rate of patients with CRD was 1607 per 100 000 persons (asthma=856, COPD=1503, ILD=2609, bronchiectasis=1463). CRD mortality was overall 54% higher than the general population. A third of patients with CRD died from respiratory-related causes. Respiratory-related mortality was constant, while cardiovascular-related mortality decreased significantly over time. COPD accounted for the majority of respiratory-related deaths (66% overall) in all patient groups except ILD.
CONCLUSIONS
Patients with CRD continue to experience substantial morbidity and mortality due to respiratory diseases. Disease-modifying intervention strategies are needed to improve outcomes for patients with CRD.
Identifiants
pubmed: 30696745
pii: thoraxjnl-2018-212514
doi: 10.1136/thoraxjnl-2018-212514
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
483-491Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: AVG is supported by an educational grant and is an employee of Boehringer Ingelheim Ltd. JKQ’s research group has received funding from MRC, Wellcome Trust, BLF, GSK, Insmed, AZ, Bayer and BI for other projects, none of which relate to this work. JKQ has received funds from AZ, GSK, Chiesi, Teva and BI for Advisory board participation or travel. VN is an NIHR clinical lecturer.