title: COPD mortality rates in Andalusia, Spain, 1975-2010: a joinpoint regression analysis.
abstract: OBJECTIVE
  To describe chronic obstructive pulmonary disease (COPD) mortality rates in Andalusia, Spain, between 1975 and 2010 using a joinpoint regression analysis.
  
  
  METHODS
  Mortality figures for Andalusian residents aged >40 years from 1975 to 2010 were obtained from the National  Institute of Statistics. Causes of death were classified based on the 8th, 9th and 10th revisions of the International Classification of Diseases. Crude, standardised (SMR) and 40- to 70-year truncated mortality rates were calculated. Trends were analysed using joinpoint regression analysis  to identify significant trend changes, and an annual percentage of change (APC) was computed from each trend.
  
  
  RESULTS
  Mortality rates showed a downward trend for both sexes. The SMR ranged from 109.9 to 98.0 deaths/100 000 males, and between 35.8 and 12.0 deaths/100 000 females.  An increase in the average age at death for men and women with COPD was also observed. Both sexes experienced an increase in SMR in the early 1980s, although female mortality rates began to decline in 1985 (APC -5.8% thereafter), whereas those for males remained high until 1998 (APC  -4% thereafter).
  
  
  CONCLUSIONS
  COPD mortality remains higher in male than female inhabitants of Andalusia. These rates have decreased following different sex- and age-dependent patterns.
authors.affiliation: Unidad Medico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio, Seville, Spain. lcampos@separ.es
authors.forename: J L
authors.initials: JL
authors.lastname: López-Campos
authors.forename: M
authors.initials: M
authors.lastname: Ruiz-Ramos
authors.forename: J B
authors.initials: JB
authors.lastname: Soriano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D012044:Regression Analysis; D013030:Spain / Q000453:epidemiology; D013997:Time Factors