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Original Research: COPD |

Changes in Mortality Among US Adults With COPD in Two National Cohorts Recruited From 1971-1975 and 1988-1994Changes in Mortality in US Adults With COPD

Earl S. Ford, MD, MPH; David M. Mannino, MD, FCCP; Guixiang Zhao, MD, PhD; Chaoyang Li, MD, PhD; Janet B. Croft, PhD
Author and Funding Information

From the Division of Adult and Community Health (Drs Ford, Zhao, and Croft), National Center for Chronic Disease Prevention and Health Promotion, and Division of Behavioral Surveillance (Dr Li), Public Health Surveillance Program Office, Centers for Disease Control and Prevention, Atlanta, GA; and Department of Medicine (Dr Mannino), University of Kentucky College of Medicine, Lexington, KY.

Correspondence to: Earl S. Ford, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS K67, Atlanta, GA 30341; e-mail: eford@cdc.gov


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).


© 2012 American College of Chest Physicians


Chest. 2012;141(1):101-110. doi:10.1378/chest.11-0472
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Background:  COPD is a major contributor to the global burden of disease. Our objective was to examine changes in the mortality rate among persons with COPD in the United States.

Methods:  We conducted prospective studies using data from 5,185 participants in the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study (baseline examination from 1971-1975; follow-up from 1992-1993) and 10,954 participants of the NHANES III Linked Mortality Study (baseline examination from 1988-1994; follow-up through 2006).

Results:  The age-adjusted rate (per 1,000 person-years) among participants with moderate or severe COPD (23.9 and 20.2) was about 2.5 to 3 times higher than the rate among participants with normal lung function (10.4 and 6.2) in NHANES I and NHANES III, respectively. Compared with NHANES I, the mortality rate among participants in NHANES III decreased by 15.8% for those with moderate or severe COPD, 25.2% for those with mild COPD, 35.9% for those with respiratory symptoms with normal lung function, 16.6% for those with restrictive impairment, and 40.1% for those with normal lung function. However, the decrease did not reach statistical significance among participants with moderate or severe COPD. The decreases in the mortality rate among men with moderate or severe COPD (−17.8%) or with restrictive impairment (−35.1%) exceeded the changes among women (+3% and −6.1%, respectively).

Conclusions:  The secular decline in the mortality rate in the United States benefited people with COPD less than those with normal lung function.

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