摘要 : Introduction:China faces a growing burden of chronic obstructive pulmonary disease(COPD).Previous mortality estimations were primarily based on the underlying cause of death.This study analyzed COPD-associated death and its comorb... 展开 Introduction:China faces a growing burden of chronic obstructive pulmonary disease(COPD).Previous mortality estimations were primarily based on the underlying cause of death.This study analyzed COPD-associated death and its comorbidities using all COPD cases listed on the chain of events on death certificates.Methods:A retrospective analysis of the National Mortality Surveillance System(NMSS)was conducted to estimate COPD-associated mortality from 2014 to 2021.Age-standardized mortality rates(ASMRs)were calculated stratified by sex,region,and residence.Joinpoint regression was used to estimate the average annual percentage change(AAPC)during the study period.Results:From 2014 to 2021,the ASMR of COPD decreased from 91.85 to 45.90 per 100,000 population.Significant but uneven decreases in COPD mortality were observed across gender[females:AAPC:−11.2%,95%confidence interval(CI):−11.9 to−10.4%;males:AAPC:−8.0%,95%CI:−9.2 to−6.8%],regions(eastern:AAPC:−10.7%,95%CI:−11.5 to−9.9%;central:AAPC:−9.9%,95%CI:−10.9 to−8.9%;western:AAPC:−7.7%,95%CI:−10.6 to−4.7%),and residential areas(urban:AAPC:−10.9%,95%CI:−12.3 to−9.5%;rural:AAPC:−8.3%,95%CI:−9.1 to−7.4%).Other than COPD,cardiovascular diseases and respiratory conditions were the major underlying causes of death in COPDassociated mortality.Conclusions:COPD is a significant comorbidity of other disorders in China.Although COPDassociated mortality substantially decreased from 2014 to 2021,the burden remained high in underdeveloped regions. 收起