ANALYSIS OF DEATHS DUE TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN LITHUANIA IN 2019 AND 2022

Abstract

Chronic obstructive pulmonary disease (COPD) is a debilitating chronic disease that significantly affects daily activities and quality of life. Approximately 3 million people die from this disease every year, making it the third leading cause of death in the world after ischemic heart disease and stroke. Rising tobacco consumption, population ageing, and the lack of effective treatment are all contributing to a projected increase in COPD-related mortality. Despite its high mortality rate, deaths directly attributable to COPD may be underestimated, as comorbidities such as cardiovascular disease are often recorded as the primary cause of death on death certificates. Aim of the study. To assess the main causes of death among individuals in Lithuania whose death certificates listed a diagnosis of COPD in 2019 and 2022. Methods. This study presents findings from a retrospective cohort analysis based on death certificate data of Lithuanian patients. The data were retrieved from national population registers and analysed via the State Data Reuse Platform. The analysis included individuals for whom COPD (J44.0–J44.9) was listed as one of the causes of death. The primary causes of death included COPD (J44.0–J44.9), hypertension (I10-I15), ischemic heart disease (I20–I25), arrhythmias (I44–I49), heart failure (I50.0–I50.9), cerebral infarction, stroke or sequelae of cerebrovascular disease (I63–I64; I69), asthma (J45.0–J45.9), acute pneumonia (J18), and acute respiratory failure (J96). Results. In 2019, COPD (as the underlying cause, immediate cause, intermediate cause, or contributing condition not directly related to the main cause of death) was indicated in 0.72% of all deaths, and 2022 – 0.62%. Among those with a recorded COPD diagnosis, COPD was identified as the underlying cause of death in 54% of cases in 2019 and 45% in 2022. Cardiovascular diseases were the primary cause of death in 32% of cases in 2019 and 35% in 2022. Other commonly recorded underlying causes of death included ischaemic heart disease (22% in both years), heart failure, and acute pneumonia (each up to 10%). Conclusions. This study indicates that COPD is underreported as a leading cause of death. Notably, COPD and cardiovascular diseases frequently co-occur, with cardiovascular conditions recorded as the primary cause of death in roughly one-third of cases where COPD was also diagnosed.