Changing causes of mortality for people with chronic respiratory diseases

Abstract

Background: Whilst respiratory disease remains a common cause of death, it is not known whether causes of death in people with chronic respiratory diseases (CRD) have changed over time. Methods: We used primary care data (Clinical Practice Research Datalink) linked with mortality data (Office for National Statistics) to determine the most common causes of mortality in people with asthma, bronchiectasis, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases (ILD), during 2005-14 in England. We calculated all-cause and disease-specific mortality rates. Results: We identified 483,099 CRD patients, 48.6% were female (n=36,862), 25% current smokers (n=18,720) and mean age at death was 78 years (SD = 11). The age standardised mortality rate of patients with CRD was 1,607 per 100,000 person years (asthma=856, COPD=1,503, ILD=2,609, bronchiectasis=1,463). CRD mortality rate was 54% higher than the general population. Leading causes of death in CRD patients were respiratory (32%), circulatory (26%), and neoplasms (24%). In asthma patients it was circulatory (28%), neoplasms (27%), and respiratory (24%). Conclusions: This is the most comprehensive study, to date, of causes of death in the CRD population in England. Deaths due to circulatory diseases have decreased in the past 10 years; however, there has not been the same impact on respiratory-related deaths. CRD patient mortality rates are much higher than the general population.