Objective: To analyze the prevalence and the trend of the disease burden of chronic respiratory diseases and relevant risk factors in Jiangsu province from 1990 to 2019 and provide evidence for the prevention and treatment of chronic respiratory diseases. Methods: The data from the 2019 Global Burden of Disease Study (GBD2019) were used to calculate the prevalence rate, mortality rate and disability-adjusted life year (DALY) rate. Software Joinpoint was used to calculate the annual percent change (APC) and average annual percent change (AAPC) of the standardized prevalence rate, standardized mortality rate and standardized DALY rate. The population attributable fractions (PAF) were used to estimate the proportion of chronic respiratory disease caused by different risk factors. Results: In 1990 and 2019, the prevalence rates of chronic respiratory diseases were 4.83% and 5.45%. The mortality rates were 134.91/100 000 and 80.99/100 000 respectively, and the DALY rates were 2 678.52/100 000 and 1 534.31/100 000 respectively. From 1990 to 2019, the age-standardized prevalence rate, mortality rate and DALY rate in Jiangsu showed a significant downward trend (AAPC values were -0.90%, -5.28% and -4.70% respectively, P<0.05). Tobacco use was the leading cause of chronic respiratory diseases, followed by air pollution, occupational exposure, suboptimal temperature and high BMI. Compared with 1990, the proportion of DALYs of chronic respiratory diseases attributable to tobacco use and high BMI increased in 2019. Conclusion: The overall burden of chronic respiratory diseases in Jiangsu shows a downward trend. Prevention and health education should be focused on the population with a smoking history and high BMI. At the same time, environmental management, attention to suboptimal temperature and control of occupational exposure factors should also be adopted as important means to prevent and control chronic respiratory diseases.
Humans ; Global Burden of Disease ; Respiratory Tract Diseases/mortality* ; Risk Factors ; China/epidemiology* ; Prevalence

Objective: To analyze the prevalence and the trend of the disease burden of chronic respiratory diseases and relevant risk factors in Jiangsu province from 1990 to 2019 and provide evidence for the prevention and treatment of chronic respiratory diseases. Methods: The data from the 2019 Global Burden of Disease Study (GBD2019) were used to calculate the prevalence rate, mortality rate and disability-adjusted life year (DALY) rate. Software Joinpoint was used to calculate the annual percent change (APC) and average annual percent change (AAPC) of the standardized prevalence rate, standardized mortality rate and standardized DALY rate. The population attributable fractions (PAF) were used to estimate the proportion of chronic respiratory disease caused by different risk factors. Results: In 1990 and 2019, the prevalence rates of chronic respiratory diseases were 4.83% and 5.45%. The mortality rates were 134.91/100 000 and 80.99/100 000 respectively, and the DALY rates were 2 678.52/100 000 and 1 534.31/100 000 respectively. From 1990 to 2019, the age-standardized prevalence rate, mortality rate and DALY rate in Jiangsu showed a significant downward trend (AAPC values were -0.90%, -5.28% and -4.70% respectively, P<0.05). Tobacco use was the leading cause of chronic respiratory diseases, followed by air pollution, occupational exposure, suboptimal temperature and high BMI. Compared with 1990, the proportion of DALYs of chronic respiratory diseases attributable to tobacco use and high BMI increased in 2019. Conclusion: The overall burden of chronic respiratory diseases in Jiangsu shows a downward trend. Prevention and health education should be focused on the population with a smoking history and high BMI. At the same time, environmental management, attention to suboptimal temperature and control of occupational exposure factors should also be adopted as important means to prevent and control chronic respiratory diseases.
Humans ; Global Burden of Disease ; Respiratory Tract Diseases/mortality* ; Risk Factors ; China/epidemiology* ; Prevalence

BACKGROUND: Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate. METHODS: Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics. RESULTS: The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27-1.30), 1.53 (95% CI: 1.50-1.55), and 1.46 (95% CI: 1.44-1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08-1.10), 1.10 (95% CI: 1.08-1.11), and 1.35 (95% CI: 1.32-1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54-1.42), 1.39% (95% CI: 0.82-1.97), and 0.13% (95% CI: - 1.24 to 1.48), respectively. CONCLUSION Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.
Cardiovascular Diseases/mortality* ; Cause of Death ; Climate Change/mortality* ; Cold Temperature/adverse effects* ; Hot Temperature/adverse effects* ; Humans ; Japan/epidemiology* ; Mortality/trends* ; Regression Analysis ; Respiratory Tract Diseases/mortality* ; Seasons ; Time

BACKGROUND: For the reason that many studies have been inconclusive on the effect of humidity on respiratory disease, we examined the association between absolute humidity and respiratory disease mortality and quantified the mortality burden due to non-optimal absolute humidity in Guangzhou, China. METHODS: Daily respiratory disease mortality including total 42,440 deaths from 1 February 2013 to 31 December 2018 and meteorological data of the same period in Guangzhou City were collected. The distributed lag non-linear model was used to determine the optimal absolute humidity of death and discuss their non-linear lagged effects. Attributable fraction and population attributable mortality were calculated based on the optimal absolute humidity, defined as the minimum mortality absolute humidity. RESULTS: The association between absolute humidity and total respiratory disease mortality showed an M-shaped non-linear curve. In total, 21.57% (95% CI 14.20 ~ 27.75%) of respiratory disease mortality (9154 deaths) was attributable to non-optimum absolute humidity. The attributable fractions due to high absolute humidity were 13.49% (95% CI 9.56 ~ 16.98%), while mortality burden of low absolute humidity were 8.08% (95% CI 0.89 ~ 13.93%), respectively. Extreme dry and moist absolute humidity accounted for total respiratory disease mortality fraction of 0.87% (95% CI - 0.09 ~ 1.58%) and 0.91% (95% CI 0.25 ~ 1.39%), respectively. There was no significant gender and age difference in the burden of attributable risk due to absolute humidity. CONCLUSIONS Our study showed that both high and low absolute humidity are responsible for considerable respiratory disease mortality burden, the component attributed to the high absolute humidity effect is greater. Our results may have important implications for the development of public health measures to reduce respiratory disease mortality.
China/epidemiology* ; Cities/epidemiology* ; Climate ; Humans ; Humidity/adverse effects* ; Models, Theoretical ; Nonlinear Dynamics ; Respiratory Tract Diseases/mortality* ; Sensitivity and Specificity

We examined the attributed fractions of all-cause, cardiovascular, and respiratory mortality that were attributed to extreme and moderate cold and heat during 2010-2016 in Nanjing. Our results showed that 12.81%, 19.78%, and 25.33% of all-cause, cardiovascular, and respiratory mortalities, respectively, were attributed to temperature. The highest attributed fractions for three types of mortality were at 4 ℃ and the attributed fractions were high around 4 ℃, which falls within the moderate cold temperatures. Although moderate cold has lower RR than extreme cold, it occurred on more days than did extreme cold. Therefore, health burden caused by moderate cold requires further attention in the future.
Cardiovascular Diseases ; mortality ; China ; epidemiology ; Cities ; epidemiology ; Humans ; Mortality ; Respiratory Tract Diseases ; mortality ; Risk Factors ; Temperature

PURPOSE: In May 2015, South Korea experienced an epidemic of Middle East respiratory syndrome (MERS). This study investigated the impacts of MERS epidemic on emergency care utilization and mortality in South Korea. MATERIALS AND METHODS: A natural experimental study was conducted using healthcare utilization and mortality data of the entire Korean population. The number of monthly emergency room (ER) visits was investigated to identify changes in emergency care utilization during the MERS epidemic; these trends were also examined according to patients' demographic factors, disease severity, and region. Deaths within 7 days after visiting an ER were analyzed to evaluate the impact of the reduction in ER visits on mortality. RESULTS: The number of ER visits during the peak of the MERS epidemic (June 2015) decreased by 33.1% compared to the average figures from June 2014 and June 2016. The decrease was observed in all age, sex, and income groups, and was more pronounced for low-acuity diseases (acute otitis media: 53.0%; upper respiratory infections: 45.2%) than for high-acuity diseases (myocardial infarctions: 14.0%; ischemic stroke: 16.6%). No substantial changes were detected for the highest-acuity diseases, with increases of 3.5% for cardiac arrest and 2.4% for hemorrhagic stroke. The number of deaths within 7 days of an ER visit did not change significantly. CONCLUSION: During the MERS epidemic, the number of ER visits decreased in all age, sex, and socioeconomic groups, and decreased most sharply for low-acuity diseases. Nonetheless, there was no significant change in deaths after emergency care.
Communicable Diseases, Emerging ; Coronavirus Infections ; Delivery of Health Care ; Demography ; Disaster Planning ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Heart Arrest ; Infarction ; Korea ; Middle East ; Mortality ; Otitis Media ; Respiratory Tract Infections ; Stroke

Thirty years have passed since the Korean Association of Pediatric Allergy and Respiratory Disease was founded. There have been great changes in the pattern of respiratory diseases in Korean children during the last 30 years with economic development in the country. Pneumonia remains the leading cause of childhood morbidity, despite advances in the prevention and management. The incidence and mortality of pneumonia caused by typical bacterial pathogens have been reduced. However, the predominance of Mycoplasma pneumoniae or virus-associated diseases is emerging, which suggests that novel diagnostic and therapeutic strategies are needed. Viral bronchiolitis is one of the most substantial health burdens for infants and young children worldwide. Although respiratory syncytial virus is the most common pathogen, molecular diagnostic techniques have identified many other viruses including human rhinovirus causing bronchiolitis. Bronchiectasis is a chronic respiratory condition characterized by chronic infection, airway inflammation, and progressive lung function decline. Research into the interactions between early life respiratory infections and development of bronchiectasis is imperative to halt the disease in its origin and improve adult outcomes. Acute respiratory distress syndrome (ARDS) is a severe, life-threatening lung disease with diffuse inflammatory lung injury leading to pulmonary edema and hypoxia. Although many modalities to treat ARDS have been studied, supportive therapies and lung protective ventilator support remains the mainstay. This review focuses on the current trends in research on these childhood respiratory diseases through literature review and aims to investigate the impact of Korean study results in this field.
Adult ; Anoxia ; Bronchiectasis ; Bronchiolitis ; Bronchiolitis, Viral ; Child ; Economic Development ; Humans ; Hypersensitivity ; Incidence ; Infant ; Inflammation ; Korea* ; Lung ; Lung Diseases ; Lung Injury ; Molecular Diagnostic Techniques ; Mortality ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Rhinovirus ; Ventilators, Mechanical

PURPOSE: To describe the incidence, clinical courses, and risk factors for mortality of lower respiratory tract diseases (LRDs) caused by common respiratory viruses (CRVs) in stem cell transplantation (SCT) recipients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1038 patients who received SCT between January 2007 and August 2011 at a single center in Korea. RESULTS: Seventy-one CRV-LRDs were identified in 67 (6.5%) patients. The human parainfluenza virus (HPIV) was the most common causative pathogen of CRV-LRDs at 100 days [cumulative incidence estimate, 23.5%; 95% confidence interval (CI), 3.3–43.7] and 1 year (cumulative incidence estimate, 69.2%; 95% CI, 45.9–92.5) following SCT. The 30-day overall mortality rates due to influenza-LRDs, respiratory syncytial virus-LRDs, HPIV-LRDs, and human rhinovirus-LRDs were 35.7, 25.8, 31.6, and 42.8%, respectively. Co-pathogens in respiratory specimens were detected in 23 (33.8%) patients. The overall mortality at day 30 after CRV-LRD diagnosis was 32.8% (22/67). High-dose steroid usage (p=0.025), a severe state of immunodeficiency (p=0.033), and lymphopenia (p=0.006) were significantly associated with death within 30 days following CRV-LRD diagnosis in a univariate analysis. Multivariate logistic regression analysis revealed that high-dose steroid usage [odds ratio (OR), 4.05; 95% CI, 1.12–14.61; p=0.033] and lymphopenia (OR, 6.57; 95% CI, 1.80–24.03; p=0.004) were independent risk factors for mortality within 30 days of CRV-LRDs. CONCLUSION: CRV-LRDs among SCT recipients showed substantially high morbidity and mortality rates. Therefore, the implement of an active diagnostic approaches for CRV infections is required for SCT recipients with respiratory symptoms, especially those receiving high-dose steroids or with lymphopenia.
Diagnosis ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Korea* ; Logistic Models ; Lymphopenia ; Medical Records ; Mortality ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Diseases* ; Retrospective Studies ; Rhinovirus ; Risk Factors ; Stem Cell Transplantation* ; Stem Cells* ; Steroids

OBJECTIVETo evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing.

METHODSThe daily mortality, meteorology and air pollution index data in Chongqing from the 1(st) January 2010 to the 31(st) December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed.

RESULTSThe relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08 (95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81 (95%CI: 12.31-35.31), 14.34 (95%CI: 8.98-19.70) and 4.43 (95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09 (95%CI:1.06-1.12) and 1.06 (95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34 (95%CI: 10.04-36.64), 16.39 (95%CI: 10.19-22.59) and 2.61 (95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men.

CONCLUSIONSBoth high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.

Adult ; Aged ; Cardiovascular Diseases ; mortality ; China ; epidemiology ; Cold Temperature ; adverse effects ; Female ; Hot Temperature ; adverse effects ; Humans ; Life Expectancy ; trends ; Male ; Mortality ; trends ; Nonlinear Dynamics ; Respiratory Tract Diseases ; mortality ; Temperature

BACKGROUND/AIMS: Patients with liver cirrhosis (LC) are at risk for critical events leading to Intensive Care Unit (ICU) admission. Coagulopathy in cirrhotic patients is complex and can lead to bleeding as well as thrombosis. The aim of this study was to investigate bleeding complications in critically ill patients with LC admitted to a medical ICU (MICU). METHODS: All adult patients admitted to our MICU with a diagnosis of LC from January 2006 to December 2012 were retrospectively assessed. Patients with major bleeding at the time of MICU admission were excluded from the analysis. RESULTS: A total of 205 patients were included in the analysis. The median patient age was 62 years, and 69.3% of the patients were male. The most common reason for MICU admission was acute respiratory failure (45.4%), followed by sepsis (27.3%). Major bleeding occurred in 25 patients (12.2%). The gastrointestinal tract was the most common site of bleeding (64%), followed by the respiratory tract (20%). In a multivariate analysis, a low platelet count at MICU admission (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and sepsis (OR, 8.35; 95% CI, 1.04 to 67.05) were independent risk factors for major bleeding. The ICU fatality rate was significantly greater among patients with major bleeding (84.0% vs. 58.9%, respectively; p = 0.015). CONCLUSIONS: Major bleeding occurred in 12.2% of critically ill cirrhotic patients admitted to the MICU. A low platelet count at MICU admission and sepsis were associated with an increased risk of major bleeding during the MICU stay. Further study is needed to better understand hemostasis in critically ill patients with LC.
Aged ; Blood Platelets ; Critical Illness ; Female ; Gastrointestinal Hemorrhage/blood/diagnosis/*etiology/mortality ; Hospital Mortality ; Humans ; Intensive Care Units ; Liver Cirrhosis/blood/*complications/diagnosis/mortality ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Platelet Count ; Prognosis ; Republic of Korea ; Respiratory Tract Diseases/blood/diagnosis/*etiology/mortality ; Retrospective Studies ; Risk Factors ; Sepsis/blood/complications ; Time Factors