BACKGROUND Chronic lung disease is a common cause of mortality, yet little is known about where individuals with chronic lung disease die. RESEARCH QUESTION What are the trends and factors associated with place of death among individuals with chronic lung disease? STUDY DESIGN AND METHODS We conducted a cross-sectional analysis of natural deaths using the Centers for Disease Control and Prevention Wide-ranging OnLine Data for Epidemiologic Research from 2003 to 2017 for which chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), or cystic fibrosis (CF) was the underlying cause. Place of death was categorized as hospital, home, nursing facility, hospice facility, and other. RESULTS From 2003 to 2017, more than 2.2. million deaths were primarily attributed to chronic lung disease (51.6% female, 92.4% white). Most were attributed to COPD (88.9%), followed by ILD (10.8.%), and CF (0.3%). Hospital and nursing facility deaths declined from 44.4% (n= 59,470) and 22.6% (n= 30,285) to 28.3% (n= 49,6555) and 19.7% (n= 34,495) while home and hospice facility deaths increased from 23.3% (n=31,296) and 0.1% (n=192) to 34.7% (n=60851) and 9.0% (n=15,861) respectively. Male sex, being married, and having some college education were associated with increased odds of home death while non-white race and Hispanic ethnicity were associated with increased odds of hospital death. Compared to decedents with COPD, individuals with ILD and CF had increased odds of hospital death and reduced odds of home, nursing facility or hospice facility death. INTERPRETATION Home deaths are increasing among decedents from chronic lung disease increasing the need for quality end-of-life care in this setting. Further research should explore the end-of-life needs and preferences of these patients and their caregivers with particular attention paid to patients with ILD and CF who continue to have high rates of hospital death.

中文翻译：

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慢性肺病患者的死亡地点：美国 2003 年至 2017 年的趋势和相关因素

背景慢性肺病是死亡的常见原因，但对患有慢性肺病的个体的死亡地点知之甚少。研究问题 与慢性肺病患者的死亡地点相关的趋势和因素是什么？研究设计和方法 我们使用疾病控制和预防中心 2003 年至 2017 年的流行病学研究范围广泛的在线数据对自然死亡进行了横断面分析，其中慢性阻塞性肺病 (COPD)、间质性肺病 (ILD) ，或囊性纤维化 (CF) 是根本原因。死亡地点分为医院、家庭、护理机构、临终关怀机构和其他。结果 2003年至2017年，超过2.2。百万人死亡主要归因于慢性肺病（51.6% 女性，92.4% 白人）。大多数归因于 COPD (88.9%)，其次是 ILD (10.8.%) 和 CF (0.3%)。医院和护理机构的死亡人数从 44.4%（n=59,470）和 22.6%（n=30,285）下降到 28.3%（n=49,6555）和 19.7%（n=34,495），而家庭和临终关怀机构的死亡人数从 23.3% 增加(n=31,296) 和 0.1% (n=192) 到 34.7% (n=60851) 和 9.0% (n=15,861)。男性、已婚和接受过一些大学教育与在家死亡的几率增加有关，而非白人种族和西班牙裔与住院死亡的几率增加有关。与患有 COPD 的死者相比，患有 ILD 和 CF 的人住院死亡的几率增加，而在家、护理机构或临终关怀机构死亡的几率降低。解释 慢性肺病死者在家中的死亡人数不断增加，这增加了在这种情况下对高质量临终关怀的需求。进一步的研究应该探索这些患者及其照顾者的临终需求和偏好，尤其要关注持续高住院死亡率的 ILD 和 CF 患者。