Cystic fibrosis-related mortality trends in Brazil for the 1999-2017 period: a multiple-cause-of-death study
Augusto Hasiak Santo1, Luiz Vicente Ribeiro Ferreira da Silva-Filho2,3
1. Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo (SP) Brasil (aposentado).
Insights
Mortality rates for cystic fibrosis (CF) are increasing in Brazil, with a significant rise in the median age at death. This trend highlights the evolving impact of CF on public health outcomes.
Area of Science:
- Public Health
- Epidemiology
- Medical Statistics
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
- Understanding mortality trends is crucial for public health interventions.
Purpose of the Study:
- To analyze causes of death and mortality data for cystic fibrosis in Brazil.
- To utilize a multiple-cause-of-death methodology for comprehensive analysis.
Main Methods:
- Extracted annual mortality data from 1999-2017 from the Brazilian National Ministry of Health.
- Selected death certificates listing ICD-10 code E84 (CF) as an underlying or associated cause.
- Calculated standardized mortality rates and performed joinpoint regression analysis.
Main Results:
- Identified 2,854 CF-related deaths between 1999 and 2017.
- Observed a continuous upward trend in CF death rates, with significant annual percent changes in males and females.
- Noted a substantial increase in the median age at death, from 7.5 to 56.5 years.
Conclusions:
- Significant increase in CF-related death rates in Brazil.
- Concurrent rise in the median age at death indicates improved survival.
- Respiratory diseases are the primary associated cause of death in CF patients.
Objective:
To describe causes of death and mortality data related to cystic fibrosis (CF) using a multiple-cause-of-death methodology.
Methods:
Annual mortality data for the 1999-2017 period were extracted from the Brazilian National Ministry of Health Mortality Database. All death certificates in which category E84 (CF) of the ICD-10, was listed as an underlying or associated cause of death were selected. Epidemiological and clinical data were described, and standardized mortality rates were calculated per year and for the 2000-2017 period. A joinpoint regression analysis was performed to detect changes in the mortality rates during the study period.
Results:
Overall, 2,854 CF-related deaths were identified during the study period, ranging from 68 in 1999 to 289 in 2017. CF was the underlying cause of death in 83.5% of the death certificates. A continuous upward trend in the death rates was observed, with a significant annual percent change of 6.84% (5.3-8.4%) among males and 7.50% (6.6-8.4%) among females. The median age at death increased from 7.5 years in 1999 to 56.5 years in 2017. Diseases of the respiratory system accounted for 77% of the associated causes in the death certificates that reported CF as the underlying cause of death.
Conclusions:
A significant and continuous increase in CF-related death rates was found in Brazil in the last years, as well as a concurrent increase in the median age at death.
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