Article(id=1320427710724293055, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, articleNumber=null, orderNo=null, doi=10.11847/zgggws1149270, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1762444800000, receivedDateStr=2025-11-07, revisedDate=1768492800000, revisedDateStr=2026-01-16, acceptedDate=1775232000000, acceptedDateStr=2026-04-04, onlineDate=1792744098597, onlineDateStr=2026-10-23, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792744098597, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792744098597, creator=13701087609, updateTime=1792744098597, updator=13701087609, issue=Issue{id=1320427658937225679, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='8', pageStart='897', pageEnd='1024', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792744086250, creator='13701087609', updateTime=1792747993375, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444046678544663, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444046678544664, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=955, endPage=959, ext={EN=ArticleExt(id=1320427711026282944, articleId=1320427710724293055, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Competitive risks of survival outcomes among patients with COPD in Zhejiang province: an analysis based on the monitoring data from 2014 to 2023, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective To understand the competitive risks of survival outcomes among patients with chronic obstructive pulmonary disease (COPD) in Zhejiang province, thereby providing evidence-based reference for formulating management and intervention programs for this population.
Methods Incidence cases of COPD from January 1, 2014 to December 31, 2023 were collected from the COPD Surveillance Database of Zhejiang Provincial Center for Disease Control and Prevention, and death data from January 1, 2014 to December 31, 2024 were collected from the Death Surveillance Database. Death outcomes were matched for COPD patients. With death from respiratory diseases as the target event and malignant tumors, cerebrovascular diseases, heart disease, and other diseases as competing events, sex- and age-specific competing risk analyses were performed based on the time and underlying cause of death.
Results Among the 824 536 new COPD cases in Zhejiang province from 2014 to 2023, death outcome was observed in 211 586 cases. The 1-year, 5-year, and 10-year mortality probabilities were 0.089, 0.258, and 0.425, respectively. Respiratory diseases remained the primary risk of death (10-year cumulative risk: 0.150), followed by malignant tumors (10-year cumulative risk: 0.115, with lung cancer at 0.063 and other malignant tumors at 0.052). Cerebrovascular diseases had the lowest risk of death (10-year cumulative risk: 0.051). Stratified analysis showed that for male COPD patients, the malignant tumors had the highest cumulative risk within 3 years (3-year cumulative risk: 0.063), and respiratory diseases became the factor with the highest cumulative risk after 3 years (10-year cumulative risk: 0.162). For female patients, respiratory diseases consistently posed the highest cumulative risk (10-year cumulative risk: 0.120). For patients aged < 65 years, the risk of malignant tumors was the highest (10-year cumulative risk: 0.050); for those aged ≥65 years, the risk of respiratory diseases was the highest (10-year cumulative risk: 0.206). Other factors demonstrated similar risks, which were much lower than that of respiratory diseases.
Conclusions COPD patients face complex mortality patterns, and their competitive risks show significant age and sex differences. This highlights the importance of developing personalized and multidisciplinary integrated intervention strategies for different patient subgroups to effectively improve the prognosis of COPD patients.
, authors=Pinyuan DAI, Xiaoyan ZHOU, Hao WANG, Weiwei GONG, Jin PAN, Yunqi GUAN, Na LI, Min YU, Jieming ZHONG, authorsList=Pinyuan DAI, Xiaoyan ZHOU, Hao WANG, Weiwei GONG, Jin PAN, Yunqi GUAN, Na LI, Min YU, Jieming ZHONG, authorCompany=null, correspAuthors=Jieming ZHONG, authorNote=null, correspAuthorsNote=
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320427714801156571, articleId=1320427710724293055, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=浙江省慢性阻塞性肺疾病患者生存结局竞争风险:基于2014—2023年监测数据分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的 了解浙江省慢性阻塞性肺疾病(简称“慢阻肺”)患者的生存结局竞争风险,为慢阻肺患者管理和干预方案的制定提供参考依据。
方法 收集浙江省疾病预防控制中心慢阻肺发病报告监测数据库中2014年1月1日—2023年12月31日慢阻肺发病数据和全死因监测数据库中2014年1月1日—2024年12月31日死亡数据,为慢阻肺患者匹配上相应的死亡结局,以“呼吸系统疾病死亡”为目标事件,以“恶性肿瘤”“脑血管疾病”“心脏病”和“其他疾病”为竞争事件,根据死亡时间和根本死因进行分性别和年龄的竞争风险分析。
结果 2014—2023年浙江省824 536例慢阻肺新发患者共观察到211 586例死亡结局,1年死亡概率为0.089,5年死亡概率为0.258,10年死亡概率为0.425。呼吸系统疾病仍是慢阻肺患者最主要的死亡风险(10年累计死亡风险为0.150);其次为恶性肿瘤(10年累计死亡风险为0.115),其中肺癌10年累计死亡风险为0.063,其他恶性肿瘤10年累计死亡风险为0.052;脑血管疾病的死亡风险最低(10年累计死亡风险为0.051)。分层分析结果显示,男性慢阻肺患者在3年内累计死亡风险恶性肿瘤最高(3年累计死亡风险为0.063),3年后则转变为呼吸系统疾病最高(10年累计死亡风险为0.162);女性慢阻肺患者则始终以呼吸系统疾病导致的累计死亡风险最高(10年累计死亡风险为0.120);<65岁慢阻肺患者以恶性肿瘤累计死亡风险最高(10年累计死亡风险为0.050);≥65岁慢阻肺患者以呼吸系统疾病累计死亡风险最高(10年累计死亡风险为0.206),其他死亡原因风险较为一致,远低于呼吸系统疾病。
结论 慢阻肺患者面临复杂的死亡模式,其竞争风险存在显著的年龄和性别差异,应制定个性化、多学科的综合干预策略以有效改善慢阻肺患者的预后。
, authors=戴品远, 周晓燕, 王浩, 龚巍巍, 潘劲, 关云琦, 李娜, 俞敏, 钟节鸣
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戴品远(1995—),主管医师,硕士,研究方向:流行病与卫生统计学
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戴品远(1995—),主管医师,硕士,研究方向:流行病与卫生统计学
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Journal of Thoracic Disease, 2016, 8(10): E1122-E1135., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320427715010871772, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427710724293055, xref=null, ext=[AuthorCompanyExt(id=1320427715023454685, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427710724293055, companyId=1320427715010871772, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Chronic and Non-communicable Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China), AuthorCompanyExt(id=1320427715040231902, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427710724293055, companyId=1320427715010871772, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=浙江省疾病预防控制中心慢性非传染性疾病预防与控制所,杭州 310051)])], figs=[ArticleFig(id=1320427719498777111, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427710724293055, language=EN, label=Tab.1, caption=
Causes of death and their proportions among COPD patients in different age groups in Zhejiang province
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| 项目 | 年龄/岁 | 呼吸系统疾病 | | 其他恶性肿瘤 | | 肺癌 | | 心脏病 | | 脑血管疾病 | | 其他 |
|---|
| 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% |
|---|
| 男性 | <45 | 55 | 28.80 | | 42 | 21.99 | | 29 | 15.18 | | 19 | 9.95 | | 9 | 4.71 | | 37 | 19.37 |
| 45~49 | 221 | 33.95 | | 116 | 17.82 | | 111 | 17.05 | | 50 | 7.68 | | 41 | 6.30 | | 112 | 17.20 |
| 50~54 | 661 | 32.92 | | 356 | 17.73 | | 472 | 23.51 | | 156 | 7.77 | | 74 | 3.69 | | 289 | 14.39 |
| 55~59 | 1 297 | 29.71 | | 812 | 18.60 | | 1 215 | 27.83 | | 282 | 6.46 | | 202 | 4.63 | | 558 | 12.78 |
| 60~64 | 2 735 | 29.61 | | 1 669 | 18.07 | | 2 681 | 29.02 | | 633 | 6.85 | | 502 | 5.43 | | 1 017 | 11.01 |
| 65~69 | 4886 | 29.75 | | 2 915 | 17.75 | | 4591 | 27.96 | | 1 151 | 7.01 | | 1 139 | 6.94 | | 1 739 | 10.59 |
| 70~74 | 7230 | 30.82 | | 3891 | 16.59 | | 5597 | 23.86 | | 2056 | 8.77 | | 2 129 | 9.08 | | 2 552 | 10.88 |
| 75~79 | 10 829 | 34.44 | | 4494 | 14.29 | | 5313 | 16.90 | | 3492 | 11.11 | | 3569 | 11.35 | | 3744 | 11.91 |
| 80~84 | 13 383 | 36.43 | | 4411 | 12.01 | | 3914 | 10.65 | | 5356 | 14.58 | | 4865 | 13.24 | | 4810 | 13.09 |
| 85~89 | 9551 | 38.18 | | 2 410 | 9.63 | | 1 572 | 6.28 | | 4185 | 16.73 | | 3499 | 13.99 | | 3801 | 15.19 |
| 90~94 | 3 277 | 39.47 | | 614 | 7.39 | | 292 | 3.52 | | 1 573 | 18.94 | | 1 063 | 12.80 | | 1 484 | 17.87 |
| ≥95 | 532 | 39.76 | | 72 | 5.38 | | 20 | 1.49 | | 258 | 19.28 | | 170 | 12.71 | | 286 | 21.38 |
| 女性 | <45 | 19 | 23.17 | | 22 | 26.83 | | 18 | 21.95 | | 2 | 2.44 | | 3 | 3.66 | | 18 | 21.95 |
| 45~49 | 61 | 31.94 | | 38 | 19.90 | | 28 | 14.66 | | 22 | 11.52 | | 8 | 4.19 | | 34 | 17.80 |
| 50~54 | 132 | 30.99 | | 82 | 19.25 | | 73 | 17.14 | | 52 | 12.21 | | 23 | 5.40 | | 64 | 15.02 |
| 55~59 | 201 | 27.69 | | 141 | 19.42 | | 141 | 19.42 | | 75 | 10.33 | | 39 | 5.37 | | 129 | 17.77 |
| 60~64 | 561 | 35.04 | | 277 | 17.30 | | 217 | 13.55 | | 180 | 11.24 | | 105 | 6.56 | | 261 | 16.30 |
| 65~69 | 1 033 | 34.34 | | 464 | 15.43 | | 407 | 13.53 | | 342 | 11.37 | | 289 | 9.61 | | 473 | 15.72 |
| 70~74 | 1 784 | 33.58 | | 750 | 14.12 | | 505 | 9.50 | | 726 | 13.66 | | 680 | 12.80 | | 868 | 16.34 |
| 75~79 | 2 943 | 32.34 | | 995 | 10.93 | | 688 | 7.56 | | 1 556 | 17.10 | | 1 330 | 14.61 | | 1 589 | 17.46 |
| 80~84 | 4652 | 32.35 | | 1 180 | 8.20 | | 742 | 5.16 | | 2 872 | 19.97 | | 2 327 | 16.18 | | 2 609 | 18.14 |
| 85~89 | 3962 | 32.90 | | 696 | 5.78 | | 422 | 3.50 | | 2 703 | 22.45 | | 1 871 | 15.54 | | 2 388 | 19.83 |
| 90~94 | 1 539 | 32.87 | | 228 | 4.87 | | 103 | 2.20 | | 1 082 | 23.11 | | 652 | 13.93 | | 1 078 | 23.02 |
| ≥95 | 289 | 33.45 | | 23 | 2.66 | | 10 | 1.16 | | 196 | 22.69 | | 106 | 12.27 | | 240 | 27.78 |
| 合计 | <45 | 74 | 27.11 | | 64 | 23.44 | | 47 | 17.22 | | 21 | 7.69 | | 12 | 4.40 | | 55 | 20.15 |
| 45~49 | 282 | 33.49 | | 154 | 18.29 | | 139 | 16.51 | | 72 | 8.55 | | 49 | 5.82 | | 146 | 17.34 |
| 50~54 | 793 | 32.58 | | 438 | 18.00 | | 545 | 22.39 | | 208 | 8.55 | | 97 | 3.99 | | 353 | 14.50 |
| 55~59 | 1 498 | 29.42 | | 953 | 18.72 | | 1 356 | 26.63 | | 357 | 7.01 | | 241 | 4.73 | | 687 | 13.49 |
| 60~64 | 3 296 | 30.41 | | 1 946 | 17.96 | | 2 898 | 26.74 | | 813 | 7.50 | | 607 | 5.60 | | 1 278 | 11.79 |
| 65~69 | 5919 | 30.46 | | 3 379 | 17.39 | | 4998 | 25.72 | | 1 493 | 7.68 | | 1 428 | 7.35 | | 2 212 | 11.39 |
| 70~74 | 9014 | 31.33 | | 4641 | 16.13 | | 6 102 | 21.21 | | 2 782 | 9.67 | | 2 809 | 9.76 | | 3 420 | 11.89 |
| 75~79 | 13 772 | 33.97 | | 5 489 | 13.54 | | 6 001 | 14.80 | | 5 048 | 12.45 | | 4 899 | 12.08 | | 5 333 | 13.15 |
| 80~84 | 18 035 | 35.28 | | 5 591 | 10.94 | | 4 656 | 9.11 | | 8 228 | 16.10 | | 7 192 | 14.07 | | 7 419 | 14.51 |
| 85~89 | 13 513 | 36.46 | | 3 106 | 8.38 | | 1 994 | 5.38 | | 6 888 | 18.59 | | 5 370 | 14.49 | | 6 189 | 16.70 |
| 90~94 | 4816 | 37.09 | | 842 | 6.48 | | 395 | 3.04 | | 2 655 | 20.45 | | 1 715 | 13.21 | | 2 562 | 19.73 |
| ≥95 | 821 | 37.28 | | 95 | 4.31 | | 30 | 1.36 | | 454 | 20.62 | | 276 | 12.53 | | 526 | 23.89 |
), ArticleFig(id=1320427719586857496, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427710724293055, language=CN, label=表1, caption=
浙江省不同年龄组慢阻肺患者各类死亡原因及占比
, figureFileSmall=null, figureFileBig=null, tableContent=
| 项目 | 年龄/岁 | 呼吸系统疾病 | | 其他恶性肿瘤 | | 肺癌 | | 心脏病 | | 脑血管疾病 | | 其他 |
|---|
| 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% | | 死亡例数 | 占比/% |
|---|
| 男性 | <45 | 55 | 28.80 | | 42 | 21.99 | | 29 | 15.18 | | 19 | 9.95 | | 9 | 4.71 | | 37 | 19.37 |
| 45~49 | 221 | 33.95 | | 116 | 17.82 | | 111 | 17.05 | | 50 | 7.68 | | 41 | 6.30 | | 112 | 17.20 |
| 50~54 | 661 | 32.92 | | 356 | 17.73 | | 472 | 23.51 | | 156 | 7.77 | | 74 | 3.69 | | 289 | 14.39 |
| 55~59 | 1 297 | 29.71 | | 812 | 18.60 | | 1 215 | 27.83 | | 282 | 6.46 | | 202 | 4.63 | | 558 | 12.78 |
| 60~64 | 2 735 | 29.61 | | 1 669 | 18.07 | | 2 681 | 29.02 | | 633 | 6.85 | | 502 | 5.43 | | 1 017 | 11.01 |
| 65~69 | 4886 | 29.75 | | 2 915 | 17.75 | | 4591 | 27.96 | | 1 151 | 7.01 | | 1 139 | 6.94 | | 1 739 | 10.59 |
| 70~74 | 7230 | 30.82 | | 3891 | 16.59 | | 5597 | 23.86 | | 2056 | 8.77 | | 2 129 | 9.08 | | 2 552 | 10.88 |
| 75~79 | 10 829 | 34.44 | | 4494 | 14.29 | | 5313 | 16.90 | | 3492 | 11.11 | | 3569 | 11.35 | | 3744 | 11.91 |
| 80~84 | 13 383 | 36.43 | | 4411 | 12.01 | | 3914 | 10.65 | | 5356 | 14.58 | | 4865 | 13.24 | | 4810 | 13.09 |
| 85~89 | 9551 | 38.18 | | 2 410 | 9.63 | | 1 572 | 6.28 | | 4185 | 16.73 | | 3499 | 13.99 | | 3801 | 15.19 |
| 90~94 | 3 277 | 39.47 | | 614 | 7.39 | | 292 | 3.52 | | 1 573 | 18.94 | | 1 063 | 12.80 | | 1 484 | 17.87 |
| ≥95 | 532 | 39.76 | | 72 | 5.38 | | 20 | 1.49 | | 258 | 19.28 | | 170 | 12.71 | | 286 | 21.38 |
| 女性 | <45 | 19 | 23.17 | | 22 | 26.83 | | 18 | 21.95 | | 2 | 2.44 | | 3 | 3.66 | | 18 | 21.95 |
| 45~49 | 61 | 31.94 | | 38 | 19.90 | | 28 | 14.66 | | 22 | 11.52 | | 8 | 4.19 | | 34 | 17.80 |
| 50~54 | 132 | 30.99 | | 82 | 19.25 | | 73 | 17.14 | | 52 | 12.21 | | 23 | 5.40 | | 64 | 15.02 |
| 55~59 | 201 | 27.69 | | 141 | 19.42 | | 141 | 19.42 | | 75 | 10.33 | | 39 | 5.37 | | 129 | 17.77 |
| 60~64 | 561 | 35.04 | | 277 | 17.30 | | 217 | 13.55 | | 180 | 11.24 | | 105 | 6.56 | | 261 | 16.30 |
| 65~69 | 1 033 | 34.34 | | 464 | 15.43 | | 407 | 13.53 | | 342 | 11.37 | | 289 | 9.61 | | 473 | 15.72 |
| 70~74 | 1 784 | 33.58 | | 750 | 14.12 | | 505 | 9.50 | | 726 | 13.66 | | 680 | 12.80 | | 868 | 16.34 |
| 75~79 | 2 943 | 32.34 | | 995 | 10.93 | | 688 | 7.56 | | 1 556 | 17.10 | | 1 330 | 14.61 | | 1 589 | 17.46 |
| 80~84 | 4652 | 32.35 | | 1 180 | 8.20 | | 742 | 5.16 | | 2 872 | 19.97 | | 2 327 | 16.18 | | 2 609 | 18.14 |
| 85~89 | 3962 | 32.90 | | 696 | 5.78 | | 422 | 3.50 | | 2 703 | 22.45 | | 1 871 | 15.54 | | 2 388 | 19.83 |
| 90~94 | 1 539 | 32.87 | | 228 | 4.87 | | 103 | 2.20 | | 1 082 | 23.11 | | 652 | 13.93 | | 1 078 | 23.02 |
| ≥95 | 289 | 33.45 | | 23 | 2.66 | | 10 | 1.16 | | 196 | 22.69 | | 106 | 12.27 | | 240 | 27.78 |
| 合计 | <45 | 74 | 27.11 | | 64 | 23.44 | | 47 | 17.22 | | 21 | 7.69 | | 12 | 4.40 | | 55 | 20.15 |
| 45~49 | 282 | 33.49 | | 154 | 18.29 | | 139 | 16.51 | | 72 | 8.55 | | 49 | 5.82 | | 146 | 17.34 |
| 50~54 | 793 | 32.58 | | 438 | 18.00 | | 545 | 22.39 | | 208 | 8.55 | | 97 | 3.99 | | 353 | 14.50 |
| 55~59 | 1 498 | 29.42 | | 953 | 18.72 | | 1 356 | 26.63 | | 357 | 7.01 | | 241 | 4.73 | | 687 | 13.49 |
| 60~64 | 3 296 | 30.41 | | 1 946 | 17.96 | | 2 898 | 26.74 | | 813 | 7.50 | | 607 | 5.60 | | 1 278 | 11.79 |
| 65~69 | 5919 | 30.46 | | 3 379 | 17.39 | | 4998 | 25.72 | | 1 493 | 7.68 | | 1 428 | 7.35 | | 2 212 | 11.39 |
| 70~74 | 9014 | 31.33 | | 4641 | 16.13 | | 6 102 | 21.21 | | 2 782 | 9.67 | | 2 809 | 9.76 | | 3 420 | 11.89 |
| 75~79 | 13 772 | 33.97 | | 5 489 | 13.54 | | 6 001 | 14.80 | | 5 048 | 12.45 | | 4 899 | 12.08 | | 5 333 | 13.15 |
| 80~84 | 18 035 | 35.28 | | 5 591 | 10.94 | | 4 656 | 9.11 | | 8 228 | 16.10 | | 7 192 | 14.07 | | 7 419 | 14.51 |
| 85~89 | 13 513 | 36.46 | | 3 106 | 8.38 | | 1 994 | 5.38 | | 6 888 | 18.59 | | 5 370 | 14.49 | | 6 189 | 16.70 |
| 90~94 | 4816 | 37.09 | | 842 | 6.48 | | 395 | 3.04 | | 2 655 | 20.45 | | 1 715 | 13.21 | | 2 562 | 19.73 |
| ≥95 | 821 | 37.28 | | 95 | 4.31 | | 30 | 1.36 | | 454 | 20.62 | | 276 | 12.53 | | 526 | 23.89 |
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