title: The prevalence, characteristics, and impact of chronic obstructive pulmonary disease in North Carolina.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. We describe the prevalence, characteristics, and impact of COPD in North Carolina.
  
  
  METHODS
  We determined the prevalence of self-reported COPD and characteristics of affected persons using data from the 2009 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. We also determined the number of persons with COPD in nursing homes and adult care or family care homes. We drew conclusions about the impact of COPD from data regarding mortality, hospitalizations, emergency department visits, prednisone use, and health impairment.
  
  
  RESULTS
  The age-adjusted prevalence of COPD among BRFSS survey respondents was 5.6%, and about 10,000 adults in nursing homes, adult care homes, or family care homes had COPD; thus we estimate that nearly 408,000 adults in North Carolina had COPD in 2009. Rates of self-reported COPD were highest among elderly individuals, smokers, individuals with less education, and those with lower incomes. Mental and physical impairment were significantly worse in those with COPD, two-thirds of whom reported that dyspnea affected their quality of life. Prednisone use was reported by 27.4% of persons with COPD, 11.4% of respondents with COPD had been hospitalized for this condition within the preceding year, and COPD admissions accounted for 1.44% of all hospital charges. Asthma, heart disease, stroke, and diabetes mellitus were significantly more common in persons with COPD. In terms of mortality, COPD was the fourth leading cause of death (n = 4,324); 77% of COPD deaths were among persons who had no education beyond high school, and 53% of those who died were women. COPD was reported in 17.1% of deaths from all causes, 21% of deaths from asthma, 10.1% of deaths from lung cancer, and 6.7% of deaths from heart disease.
  
  
  CONCLUSIONS
  These data are based on population and health care database estimates and are approximations.
  
  
  CONCLUSIONS
  COPD has substantial effects on the health of North Carolinians.
authors.affiliation: Campbell University, College of Pharmacy and Health Sciences, Division of Pharmacy Practice, Leslie Campbell Ave., Buies Creek, NC 27506, USA. roy.pleasants@duke.edu.
authors.forename: Roy A
authors.initials: RA
authors.lastname: Pleasants
authors.forename: Harry
authors.initials: H
authors.lastname: Herrick
authors.forename: Winston
authors.initials: W
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000401:mortality; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors