Mortality caused by idiopathic pulmonary fibrosis in the State of Rio Grande do Sul (Brazil)

Abstract

Epidemiologic data on idiopathic pulmonary fibrosis are relatively scarce, and its real incidence and prevalence are unknown. Recent studies suggest that mortality due to idiopathic pulmonary fibrosis is rising in developed countries. OBJECTIVE: To describe mortality caused by idiopathic pulmonary fibrosis in the State of Rio Grande do Sul (RS), Brazil, from 1970 to 2000, analyzing its trend and comparing it with that from other countries. METHOD: Prevalence study, using data from the Brazilian Institute of Geography and Statistics (IBGE), analyzing death certificates in which idiopathic pulmonary fibrosis was stated as the ultimate cause of death. RESULTS: Annual mortality rate adjusted to the population was 0.22/100,000 people in the 1970’s, 0.3/100,000 people in the 1980’s, and 0.48/100,000 people in the 1990’s. Total mortality raised 36% from 1970 to 1980, and 73% from 1980 to 1990. The mortality rate adjusted to the population raised 36% and 60% during the same periods. The rise in both total and adjusted mortality from IPF was statistically significant (p < 0.05). The mean mortality rate per 100,000 inhabitants between 1996 and 1998, however, was 0.683, corresponding to a 70% increase when compared to the previous three-year period, which was 0.4 (p = 0.0002), probably reflecting coding practices. CONCLUSION: There was a significant increase in IPF mortality in RS from 1970 to 2000, partly due to changes in coding practices. This increase is in conformity with observations in other countries, although mortality rates in RS are considerably lower

Global incidence and mortality of idiopathic pulmonary fibrosis: a systematic review

“…Eight studies examined mortality from IPF [1,9,[15][16][17][18][19][20] and 28 reported incidence [1-3, 14, 19, 21-43]. Most studies were from Europe and North America (25 studies), with a minority from Asia (five studies) and South America (two studies).…”

“…Two studies compared mortality data across countries [9,15], three explored data from the USA [16][17][18], one looked specifically at the UK [1] and two reported data from Brazil [19,20]. All studies commented on change over time.…”

“…Age-adjusted mortality increased from 3.2 per 100 000 in 1979, to 3.65 per 100 000 in 1991 [16] Two Brazilian studies reported lower levels of mortality from IPF. RUFINO et al [19] noted an increase in mortality from 0.65 per 100 000 in 1996 to 1.21 per 100 000 in 2010 and FORTUNA et al [20] noted an increase in mortality in the southern Brazilian state of Rio Grande do Sul, from 0.22 per 100 000 (1970s), to 0.48 per 100 000 (1990s).…”

“…In the USA, mortality statistics were lower and estimates using narrow criteria suggested an incidence of 5-8 per 100 000 [2,17,18,30]. Both incidence and mortality studies from South America suggested a low incidence (0.4-1.2 per 100 000) [19,20]. Insurance claims-based incidence studies from East Asia also showed a low incidence (1.2-3.8 per 100 000) [3,24,25], although routine mortality statistics from Japan suggested a higher incidence (adjusted mortality rate of 10.26 per 100 000 for broad coding).…”

“…Increasing incidence rates were particularly evident in UK datasets [1,21], but also noted in South America [19,20], East Asia [3] and Europe [34]. However, mortality data from the USA appeared to plateau in some studies, and a decline was noted in studies from the USA [15,30] and Denmark [23].…”