Chronic obstructive pulmonary diseases (COPD) are the fourth leading cause of death in America, accounting for nearly 105,000 deaths in 1995. Mortality rates from COPD have increased slightly over the past decade, and in 1992 it passed accidents as the fourth leading cause of death in the United States. In 1993, 63.5 years of potential life were lost due to COPD for every 100,000 persons under age 65 years. Death rates from COPD are greater for men than for women, and for white persons than for black persons.
According to 1994 data, over 14.5 million Americans suffer from asthma, and more than 2 million Americans suffer from emphysema. In addition, over 14 million cases of chronic bronchitis were reported in the United States in 1994. The South has the greatest prevalence of asthma and chronic bronchitis, while the Northeast has the lowest.
In 1994 there were 451,000 hospital discharges of inpatients with a first-listed diagnosis of asthma, compared with 201,000 discharges in 1978. There were nearly 500,000 discharges for chronic bronchitis in 1993, compared with 259,000 in 1978, and over 250,000 discharges for emphysema in 1994, compared with 64,000 in 1978. Asthma patients spent an average of 4 days in the hospital in 1994, compared with 5.8 days in 1978. Patients under age 15 years spent an average of 2.5 days in the hospital for asthma in 1994, compared with 3.9 days in 1978. There were 981,000 inpatient surgical procedures performed on the respiratory system in 1994. Almost half of these procedures were performed on patients aged 65 years and over, and over 750,000 were performed on patients aged 45 years and over. Nearly a third of all procedures performed on the respiratory system were diagnostic in nature.
Nearly 12 million visits to hospital emergency departments in 1994 were due to diseases of the respiratory system. Over 1.6 million visits were by patients with a principal diagnosis of asthma. Another 1.35 million had a principal diagnosis of bronchitis (either acute or chronic). Nearly 15 million chest x rays were performed on emergency department patients and approximately 377,000 endotracheal intubations were performed on these patients. Two bronchodilators/antiasthmatics, Proventil and albuterol sulfate, accounted for over 2.7 million or 2 percent of all drugs prescribed at emergency department visits.
Nearly 5.9 million visits were made to hospital outpatient departments in 1994 for respiratory diseases, where over 1.8 million chest x rays were performed. Over a million visits resulted in a principal diagnosis of asthma. Proventil was the ninth most frequently prescribed drug at outpatient department visits, accounting for 778,000 prescriptions, while another bronchodilator/antiasthmatic, Ventolin, was the 20th most frequently prescribed drug (592,000).
In addition, 93.5 million office visits were made to physicians for respiratory diseases in 1994. More than 10.7 million of these visits resulted in a principal diagnosis of asthma, and more than 10.4 million resulted in a principal diagnosis of bronchitis (all types). Ventolin was the 15th most frequently prescribed drug at office visits, accounting for over 6.8 million prescriptions.
For further information about "Monitoring Health Care in America" please contact NCHS, Office of Public Affairs ( 301)-436-7551 or via e-mail at paoquery@nch10a.em.cdc.gov.
Vol. 43, No. 7, Supplement. Advance Report of Final Mortality Statistics, 1993.