Mortality from chronic lower respiratory disease complicated by respiratory failure increased slightly between 1999 and 2023 (AAPC 0.40; 95% CI 0.10-0.69), with persistent demographic disparities.
Observational (n=1,438,986)
Yes
Mortality from CLRD complicated by respiratory failure in the US increased slightly between 1999 and 2023, with persistent disparities by geography, sex, and race.
Effect estimate: AAPC 0.40 (95% CI 0.10-0.69)
Abstract Rationale Chronic lower respiratory diseases (CLRD) and respiratory failure (RF) remain among the leading causes of death for adults in the United States. Understanding how mortality has changed over time, particularly across demographic and regional groups, can help inform prevention efforts and health policy priorities aimed at reducing the burden of respiratory diseases. Methods In order to identify adults whose underlying causes of death included both CLRD and RF, this population-based retrospective study examined national mortality data from the CDC WONDER database from 1999 to 2023. Mortality increased slightly over the course of the 25 years (AAPC = 0.40; 95% CI: 0.10-0.69). Although female mortality rates steadily increasing after 2007, men’s mortality rates were still consistently higher than women’s. We analyzed age-adjusted mortality rates per 100,000 people, accounting for variations in sex, race, and ethnicity; age group; region; urban or rural locality; and the specific disease type. This ensured that any observed changes were attributable to genuine disparities in mortality rather than fluctuations in population composition. Joinpoint regression was used to estimate annual and average annual percent changes (AAPC) with associated 95% confidence intervals to assess temporal trends. Results Of the 1,438,986 recorded deaths, 742,879 were among females and 696,107 were among males. Overall mortality declined until 2007, remained stable until 2018, rose sharply between 2018 and 2021, and then declined again in the years that followed. Over the 25 years, there was a slight net increase in mortality (AAPC = 0.40; 95% CI: 0.10-0.69). Men consistently had higher mortality than women, although female rates climbed steadily after 2007. Non-Hispanic Whites had the highest mortality rate, while non-Hispanic Asians had the lowest. Among adults under 65, the increase from 2018 to 2021 was most noticeable. Mortality was consistently higher in non-metropolitan areas than in metropolitan ones, and the burden was disproportionately high in the Western and Southern states. The common cause of death among CLRD subtypes was “other COPD,” which was followed by emphysema and chronic bronchitis. Conclusion Mortality from CLRD complicated by respiratory failure increased moderately but steadily between 1999 and 2023, peaking around 2020-2021. Long-standing inequities by geography, sex, and race continue to exist, underscoring the critical need for focused interventions and access of respiratory care, particularly in high-burden and rural areas. This abstract is funded by: Not Applicable
Khan et al. (Fri,) conducted a observational in Chronic lower respiratory diseases and respiratory failure (n=1,438,986). Temporal trends was evaluated on Age-adjusted mortality rates (AAPC 0.40, 95% CI 0.10-0.69). Mortality from chronic lower respiratory disease complicated by respiratory failure increased slightly between 1999 and 2023 (AAPC 0.40; 95% CI 0.10-0.69), with persistent demographic disparities.