Mortality trends due to chronic obstructive pulmonary
                    disease in Brazil

initially, the specific COPD mortality rates were calculated from 1989 to 2009 using data collected from DATASUS (Departamento de Informática do SUS - Brazilian Health System Database). Then, the polynomial regression models from the observed functional relation were estimated based on mortality coefficients and study years.

Results:

we verified that the general mortality rates due to COPD in Brazil showed an increasing trend from 1989 to 2004, and then decreased. Both genders showed the same increasing tendencies until 2004 and decreased thereafter. The age group under 35 years old showed a linear decreasing trend. All other age groups showed quadratic tendencies, with increases until the years of 1998-1999 and then decreasing. The South and Southeast regions showed the highest COPD mortality rates with increasing trends until the years 2001-2002 and then decreased. The North, Northeast and Central-West regions showed lower mortality rates but increasing trend.

Conclusion:

this is the first report of COPD mortality stabilization in Brazil since 1980.

chronic obstructive pulmonary disease; mortality; international classification of diseases

COPD mortality rate per 100.000 inhabitants		Period average coefficient (β₀)	Average annual increment (β₁)	Acceleration (β₂)	P value (F)	Adjusted R2	Trend
1- General
	Brazil	18.226	0.324	-0,033	< 0.001	0.916	Increasing until 2004 and then decreasing
2- Gender
	Male	22.886	0.34	-0,043	< 0.001	0.911	Increasing until 2004 and then decreasing
	Female	13.650	0.31	-0.023	< 0.001	0.923	Increasing until 2004 and after decreasing
3- Age Group
	0-34 old¹ 1 Compound model.	1.270^* * Exponential values.	0.962		< 0.001	0.8	Decreasing, stabilizing at low level
	35-44 old² 2 Cubic model.	1.829	-0.023	-0.004	< 0.001	0.749	Increasing until 1998 and then decreasing
	45-54 old³ 3 Quadratic model.	9.261	-0.043	-0.012	0.001	0.47	Increasing until 1998 and then decreasing
	55-64 old⁴ 4 Quadratic model.	44.527	-0.328	-0.114	< 0.001	0.757	Increasing until 1998 and then decreasing
	> 65 yearsold⁵ 5 Quadratic model.	268.201	1.604	-0.670	< 0.001	0.739	Increasing until 1999 and then decreasing
4- Region
	South	36.459	0.482	-0.09	< 0.001	0.758	Increasing until 2002 and then decreasing
	Southeast	21.995	0.2	-0.043	< 0.001	0.819	Increasing until 2001 and then decreasing
	Central-West	17.109	0.561	-0.026	< 0.001	0.921	Increasing, stabilizing at a high level
	Northeast	374.278^* * Exponential values.	1.069		< 0.001	0.987	Increasing
	North	7.060	0.363	-0.007	< 0.001	0.956	Increasing, stabilizing at a high level

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] Correspondence: Universidade Nove de Julho, Address: Avenida Francisco Matarazzo 612, Bloco C, térreo, São Paulo - SP / Brazil. ggraudenz@gmail.com