Observational studyMedicine2026
Trends in mortality involving chronic obstructive pulmonary disease and obesity in the United States, 1999-2023: A population-based observational study.
Observational study in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic obstructive pulmonary disease (COPD) and obesity are major US public health conditions that frequently coexist. Despite adverse respiratory and cardiometabolic effects of obesity, an apparent "obesity paradox," whereby obesity has been associated with lower mortality in some patients with COPD, has been described. National mortality trends involving concurrent COPD and obesity remain poorly characterized. We examined temporal, demographic, and geographic patterns from 1999 to 2023. We conducted a retrospective, population-based analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Deaths among adults aged ≥25 years listing COPD (International Classification of Diseases, 10th Revision: J40-J44) and obesity (International Classification of Diseases, 10th Revision: E66) were identified. Age-adjusted mortality rates per 100,000 were calculated using direct standardization to the 2000 US population. Joinpoint Regression Program version 5.3.0.0 estimated annual percent changes (APCs) and average annual percent changes with 95% confidence intervals (CIs). Analyses were stratified by age, sex, race/ethnicity, region, urbanization, and state. Among 1,30,958 deaths, the age-adjusted mortality rate increased from 0.78 (95% CI: 0.74-0.82) in 1999 to 2.63 (95% CI: 2.57-2.68) in 2023 (average annual percent change: +5.14%; 95% CI: 4.09-6.21; P < .001). After increasing significantly through 2013, mortality increased nonsignificantly during 2013 to 2018 (APC: +2.11%; 95% CI: -0.39 to 4.67), rose markedly during 2018 to 2021 (APC: +17.45%; 95% CI: 10.18-25.19), and declined significantly through 2023 (APC: -13.47%; 95% CI: -18.32 to -8.34). Males and adults aged ≥65 years had higher mortality burdens, with variation across racial/ethnic groups, urbanization levels, regions, and states. Interpretation is limited by unavailable individual-level factors, including smoking, COPD severity, comorbidities, and socioeconomic characteristics. Mortality involving concurrent COPD and obesity increased substantially from 1999 to 2023, with marked demographic and geographic variation and an increase during the COVID-19 pandemic. These population-level associations do not establish causality. Integrated pulmonary and metabolic care, targeted prevention, and improved access in underserved communities may help address observed disparities.
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