Chest
Original ResearchCOPDChanges in Mortality Among US Adults With COPD in Two National Cohorts Recruited From 1971-1975 and 1988-1994
Section snippets
Materials and Methods
We used data from the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study (baseline examination from 1971-1975; follow-up through part of 1993) and the NHANES III Linked Mortality study (baseline examination from 1988-1994; follow-up through 2006).6, 7 Participants of the original surveys were selected by use of a stratified multistage probability sample and were deemed to be representative of the civilian noninstitutionalized population in the United
Results
Of the 6,902 NHANES I participants aged 25 to 74 years who attended the mobile examination center, 5,533 were assigned a GOLD classification. Exclusions of missing values of study variables and loss to follow-up reduced the sample to 5,185 participants. Of the 12,831 eligible NHANES III participants aged 25 to 74 years who attended the mobile examination center, 12,016 were assigned a GOLD classification. After exclusions of missing values of other study variables, 10,954 NHANES III
Discussion
The present analyses of two nationally representative cohorts of adults in the United States indicate that among adults with either COPD or with restrictive impairment, the age-adjusted mortality rate improved but not always significantly. However, adults with moderate or severe COPD or with restrictive impairment failed to experience a reduction in mortality similar to that experienced by adults with mild COPD, respiratory symptoms alone, or normal lung function. Furthermore, men with moderate
Conclusions
The present analyses suggest that the relative change in the all-cause mortality rate among adults with moderate to severe COPD was smaller than that among adults with normal lung function. Consequently, the mortality gap between these groups of adults failed to shrink. Of note was the stagnating all-cause mortality rate among women with moderate to severe COPD. If our results are confirmed, the reasons for the suboptimal change in the mortality rate among patients with COPD will require
Acknowledgments
Author contributions: Dr Ford had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Ford: contributed to the study concept and design, acquisition of data, analysis and interpretation of data, statistical analysis, study supervision, drafting of the manuscript, and critical revisions of the manuscript for important intellectual content.
Dr Mannino: contributed to the study concept and design, acquisition of
References (31)
- et al.
Global Initiative on Obstructive Lung Disease (GOLD) classification of lung disease and mortality: findings from the Atherosclerosis Risk in Communities (ARIC) study
Respir Med
(2006) - et al.
Obstructive and restrictive lung disease and markers of inflammation: data from the Third National Health and Nutrition Examination
Am J Med
(2003) - et al.
COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program
Chest
(2005) - et al.
Pneumococcal vaccination for patients with COPD: current practice and future directions
Chest
(2008) - et al.
Compliance with influenza and pneumococcal vaccination among patients with chronic obstructive pulmonary disease consulting their medical practitioners in Catalonia, Spain
J Infect
(2007) - et al.
Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials
Chest
(2010) - et al.
Contemporary management of acute exacerbations of COPD: a systematic review and metaanalysis
Chest
(2008) - et al.
Gender bias in the diagnosis of COPD
Chest
(2001) - et al.
Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma
Respir Med
(2011) The global burden of disease: 2004 update. World Health Organization Web site
State of lung disease in diverse communities 2010. American Lung Association Web site
Morbidity & mortality: 2009 chartbook on cardiovascular, lung, and blood diseases. National Heart, Lung, and Blood Institute Web site
Lung function and mortality in the United States: data from the First National Health and Nutrition Examination Survey follow up study
Thorax
NHEFS linked mortality file. Centers for Disease Control and Prevention Web site
NHANES III linked mortality file. Centers for Disease Control and Prevention Web site
Cited by (36)
Chronic obstructive pulmonary disease mortality in Spain between 1999 and 2019
2024, Medicina ClinicaSex differences between women and men with COPD: A new analysis of the 3CIA study
2020, Respiratory MedicineCitation Excerpt :Our data suggested that the proportional weight of each of the components of the BODE index varied by sex, dyspnea by the mMRC scale and BMI being the most important parameters in women [27]. In terms of survival, population-based studies show that universally females live longer than males, but COPD epidemiological studies suggest that mortality rates are declining faster in men than in women with COPD [7,28]. Indeed there are few clinical studies that determined sex-related differences in COPD survival, with contradictory results.
Gender Differences in Chronic Obstructive Pulmonary Disease-Current Knowledge and Deficits
2017, Principles of Gender-Specific Medicine: Gender in the Genomic Era: Third EditionA Subnational Analysis of Mortality and Prevalence of COPD in China From 1990 to 2013: Findings From the Global Burden of Disease Study 2013
2016, ChestCitation Excerpt :The age-standardized death rate for all NCDs from 1990 to 2013 declined more rapidly in China (25.7%) than was seen in the overall global rate of decline (18.6%).5 Mortality due to COPD—as an important component of the global burden from NCDs—also declined in most developed countries.18-20 Our study confirms this same trend for COPD in China, as previously reported by the GBD 2010.7
Epidemiology and prevalence of chronic obstructive pulmonary disease
2014, Clinics in Chest MedicineCitation Excerpt :In the United States, studies have reported that the age-adjusted mortality rate for COPD doubled from 1970 to 2000.41 Nevertheless, a recent report by Ford and colleagues10 that included an analysis from data in the NHANES I and NHANES III studies, found that compared with NHANES I, the mortality rate among participates in the NHANES III decreased by 15.8% for participants with moderate or severe COPD and 25.2% for those with mild COPD, suggesting that overall mortality attributed to COPD may be decreasing, but there was a lesser decrease in mortality rate in women with moderate or severe COPD compared with men (3% vs 17.8%). A recent assessment of smoking-related mortality in the United States evaluated temporal trends in sex-specific, smoking-related mortality across 3 time periods (1959–1965, 1982–1988, and 2000–2010) in 7 large cohorts.
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).