Trends in Morbidity and Mortality from COPD in Brazil, 2000 to 2016

Objective: To examine the trends in overall COPD mortality, as well as trends in in-hospital morbidity and mortality due to COPD, in Brazil, and to validate predictive models.

Methods: This was a population-based study with a time-series analysis of cause-specific morbidity and mortality data for individuals ≥ 40 years of age, obtained from national health information systems for the 2000-2016 period. Morbidity and mortality rates, stratified by gender and age group, were calculated for the same period. We used regression analyses to examine the temporal trends and double exponential smoothing in our analysis of the predictive models for 2017.

Results: Over the study period, COPD mortality rates trended downward in Brazil. For both genders, there was a downward trend in the southern, southeastern, and central-western regions. In-hospital morbidity rates declined in all regions, more so in the south and southeast. There were significant changes in the number of hospitalizations, length of hospital stay, and hospital expenses. The predictive models for 2017 showed error rates below 9% and were therefore validated.

Conclusions: In Brazil, COPD age-adjusted mortality rates have declined in regions with higher socioeconomic indices, where there has been an even sharper decrease in all in-hospital morbidity and mortality variables. In addition to factors such as better treatment adherence and reduced smoking rates, socioeconomic factors appear to be involved in controlling COPD morbidity and mortality. The predictive models estimated here might also facilitate decision making and the planning of health policies aimed at treating COPD.