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厦门市居民2012 — 2022年慢性阻塞性肺疾病发病和死亡趋势分析

Trends in incidence and mortality of chronic obstructive pulmonary disease among residents of Xiamen city from 2012 to 2022: analysis of hospital records and death registration data

  • 摘要:
    目的 分析福建省厦门市居民2012 — 2022年慢性阻塞性肺疾病(COPD)的发病和死亡趋势,为该地区居民COPD的预防控制提供参考依据。
    方法 依托厦门市健康医疗大数据信息平台收集2012年1月1日 — 2022年12月31日在厦门市全部医疗卫生机构就诊的COPD患者的个人基本信息和诊疗信息,并与人口死亡事件登记管理系统进行COPD死亡数据的匹配,计算发病率、标化发病率、死亡率和标化死亡率,应用Joinpoint模型计算年度变化百分比(APC)和平均年度变化百分比(AAPC)分析厦门市居民2012 — 2022年COPD发病和死亡的变化趋势。
    结果 厦门市居民2012 — 2022年COPD发病率和标化发病率依次为162.69/10万和140.63/10万、187.90/10万和167.88/10万、220.63/10万和218.19/10万、230.48/10万和223.58/10万、282.77/10万和276.87/10万、268.19/10万和266.70/10万、296.16/10万和295.78/10万、349.67/10万和343.48/10万、199.05/10万和190.35/10万、213.45/10万和208.62/10万、245.41/10万和240.19/10万,居民2012 — 2022年COPD发病率和标化发病率变化趋势均无统计学意义(均P > 0.05),但2012 — 2018年发病率(APC = 10.44%,t = 2.57,P = 0.042)和2012 — 2017年标化发病率(APC = 15.58%,t = 2.76,P = 0.033)均呈上升趋势;厦门市居民2012 — 2022年COPD死亡率和标化死亡率依次为14.47/10万和14.74/10万、16.19/10万和16.46/10万、19.77/10万和19.07/10万、24.66/10万和22.79/10万、30.42/10万和28.23/10万、33.05/10万和31.87/10万、36.30/10万和35.16/10万、38.39/10万和36.33/10万、34.08/10万和30.75/10万、40.37/10万和37.70/10万、45.37/10万和41.39/10万,居民2012 — 2022年COPD死亡率(AAPC = 12.20%,t = 7.6,P < 0.001)和标化死亡率(AAPC = 10.60%,t = 5.7,P < 0.001)变化趋势均呈总体上升趋势;厦门市不同特征居民中,男性、女性、 < 60岁、60~69岁、70~79岁和 ≥ 80岁居民2012 — 2022年的COPD死亡率总体均呈上升趋势(均P < 0.05),男性和女性居民2012 — 2022年的COPD标化死亡率总体均呈上升趋势(均P < 0.05)。
    结论 厦门市居民2012 — 2018年COPD发病率和2012 — 2017年标化发病率均呈上升趋势,2012 — 2022年死亡率及标化死亡率均呈上升趋势。

     

    Abstract:
    Objective To analyze the trends in incidence and mortality of chronic obstructive pulmonary disease (COPD) among residents of Xiamen city, Fujian province from 2012 to 2022, and to provide a reference for the prevention and control of COPD in the population.
    Methods Personal medical records of COPD patients, who visited any medical and health institutions in Xiamen city from 2012 to 2022, were extracted from the Xiamen City Health and Medical Big Data Information Platform. The collected COPD mortality data were matched with records in the city′s death registration management system. Crude and standardized rates of COPD incidence and mortality were calculated. Joinpoint model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of COPD incidence and mortality from 2012 to 2022.
    Results For the city residents from 2012 to 2022, the annual crude incidence rates (1/100 000) of COPD were 162.69,187.90, 220.63, 230.48, 282.77, 268.19, 296.16, 349.67,199.05, 213.45, and 245.41 and the annual standardized incidence rates (1/100 000) of COPD were 140.63, 167.88, 218.19, 223.58, 276.87, 266.70, 295.78, 343.48, 190.35, 208.62, and 240.19, respectively. There were no significant changing trends observed in both crude and standardized incidence rate of COPD during the whole period (both P > 0.05), but both the crude incidence rate (APC = 10.44%, t = 2.57; P = 0.042) from 2012 to 2018 and the standardized incidence rate (APC = 15.58%, t = 2.76; P = 0.033) from 2012 to 2017 showed an increasing trend. During the study period, the annual crude mortality rates (1/100 000) for COPD were 14.47, 16.19, 19.77, 24.66, 30.42, 33.05, 36.30, 38.39, 34.08, 40.37, and 45. 37 and the annual standardized mortality rates (1/100 000) of COPD were 14.74, 16.46, 19.07, 22.79, 28.23, 31.87, 35.16, 36.33, 30.75, 37.70, and 41.39, respectively; both the crude mortality rate (AAPC = 12.20%, t = 7.6, P < 0. 001) and the standardized mortality rate (AAPC = 10.60%, t = 5.7, P < 0.001) showed a significant increasing trend; further subgroup analysis showed that the increasing trend of the crude COPD mortality rate was significant for male and female residents and for residents aged 60 – 69, 70 – 79, and ≥ 80 years (all P < 0.05), and the increasing trend of standardized COPD mortality rate was significant for both male and female residents (both P < 0.05).
    Conclusion Among the residents of Xiamen city, the COPD incidence rate from 2012 to 2018 and the standardized incidence rate of COPD from 2012 to 2017 showed an increasing trend; the crude and standardized mortality rates of COPD also showed an increasing trend from 2012 to 2022.

     

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