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Luo Y, Wang M, Tian Y. Trends and age-period-cohort effects on incidence and mortality of asthma in Sichuan Province, China, 1990-2019. BMC Pulm Med 2022; 22:298. [PMID: 35922772 PMCID: PMC9351065 DOI: 10.1186/s12890-022-02059-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background The provinces in western China have undergone rapid urbanization and industrialization, particularly since the Chinese government launched the Great Western Development Strategy in 2000. We examined the time trends and contributions of age, period, and cohort effects to asthma incidence and mortality in Sichuan Province, a populous province in western China, from 1990 to 2019. Methods The data of Sichuan Province from 1990 to 2019 were extracted from the Global Burden of Disease study 2019. Trends and average annual percentage change were estimated using joinpoint regression. Age, period, and cohort effects were estimated using an age-period-cohort model with the intrinsic estimator method. Results In the latest period (2015–2019), the highest incidence of asthma was 2004.49/100,000 in children aged < 5 years, and the highest mortality rate was 22.04/100,000 for elderly people aged > 80 years. Age-standardized rates generally remained stable (95% confidence interval [CI] − 0.21, 0.11) for incidence and declined by 4.74% (95% CI − 5.09, − 4.39) for mortality over the last 30 years. After controlling for other effects, the age effect on asthma showed that the incidence rate ratio (RR) was highest in the < 5 years age group, and the mortality RR was highest in the > 80 years age group. The period effect on incidence and mortality decreased from 1990 to 2019, respectively. A cohort effect was found the incidence RR increased slowly from the early birth cohorts to the later birth cohorts, especially after the 2005 birth cohort, whereas the mortality RR continued to decline. Conclusions There was a significant effect of older age on the asthma mortality rate over the last 30 years, and the incidence rate in children aged < 5 years increased. The relative risk of asthma incidence in the later birth cohorts increased. Effective preventive measures and public health policies should be to protect children and elderly people from potentially harmful chronic diseases.
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Affiliation(s)
- Yu Luo
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, 610000, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610000, Sichuan, China
| | - Mu Wang
- Outpatient Department, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, Sichuan, China
| | - Yumei Tian
- Department of Obstetrics Nursing, West China Second University Hospital, Sichuan University, Chengdu, China. .,West China School of Nursing, Sichuan University, Chengdu, 610000, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610000, Sichuan, China.
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Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2940296. [PMID: 32090072 PMCID: PMC7014554 DOI: 10.1155/2020/2940296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/17/2019] [Accepted: 06/24/2019] [Indexed: 11/24/2022]
Abstract
Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.
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Lin J, Xing B, Tang H, Yang L, Yuan Y, Gu Y, Chen P, Liu X, Zhang J, Liu H, Wang C, Zhou W, Sun D, Chen Y, Chen Z, Huang M, Lin Q, Hu C, Yang X, Huo J, Ye X, Zhou X, Jiang P, Zhang W, Huang Y, Dai L, Liu R, Cai S, Xu J, Zhou J. Hospitalization Due to Asthma Exacerbation: A China Asthma Research Network (CARN) Retrospective Study in 29 Provinces Across Mainland China. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:485-495. [PMID: 32141261 PMCID: PMC7061152 DOI: 10.4168/aair.2020.12.3.485] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/22/2019] [Accepted: 12/26/2019] [Indexed: 11/20/2022]
Abstract
Purpose Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients. Methods A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed. Results There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%). Conclusions Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
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Affiliation(s)
- Jiangtao Lin
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
| | - Bin Xing
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Huaping Tang
- Department of Respiration, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Lan Yang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yadong Yuan
- Department of Respiration, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuhai Gu
- Department of Respiration, Qinghai People's Hospital, Xining, China
| | - Ping Chen
- Department of Respiratory Diseases, General Hospital of Shenyang Military Command, Shenyang, China
| | - Xiaoju Liu
- Department of Respiration, The First Affiliated Hospital of Lanzhou University, Lanzhou, China
| | - Jie Zhang
- Department of Pulmonary and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, China
| | - Huiguo Liu
- Department of Respiration, Tongji Hospital, Wuhan, China
| | - Changzheng Wang
- Department of Respiration, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Wei Zhou
- Department of Respiration, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Dejun Sun
- Department of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Yiqiang Chen
- Department of Respiration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhuochang Chen
- Department of Respiration, Henan Provincial People's Hospital, Zhengzhou, China
| | - Mao Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qichang Lin
- Department of Respiration, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chengping Hu
- Department of Respiration, Xiangya Hospital, Changsha, China
| | - Xiaohong Yang
- Department of Pulmonary and Critical Care Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jianmin Huo
- Department of Respiration, The First Affiliated Hospital of Harbin Medical University, Harbin China
| | - Xianwei Ye
- Department of Respiration, Guizhou Provincial People's Hospital, Guiyang, China
| | - Xin Zhou
- Department of Respiration, Shanghai Central Hospital, Shanghai, China
| | - Ping Jiang
- Department of Respiration, Tianjin First Central Hospital, Tianjin, China
| | - Wei Zhang
- Department of Respiration, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yijiang Huang
- Department of Respiration, Hainan General Hospital, Haikou, China
| | - Luming Dai
- Department of Respiration, Kunming General Hospital of the People's Liberation Army, Kunming, China
| | - Rongyu Liu
- Department of Respiration, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shaoxi Cai
- Department of Respiration, Nanfang Hospital, Guangzhou, China
| | - Jianying Xu
- Department of Respiration, Shanxi Bethune Hospital, Taiyuan, China
| | - Jianying Zhou
- Department of Respiration, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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