Global trends in pleural infection mortality: a WHO-mortality database analysis

Background Current data suggest that the incidence of pleural infection is rising worldwide, however mortality data on global rates, trends and variations are lacking. Objectives To estimate pleural infection mortality rates across 24 Countries from 1994 to 2020 worldwide, using death certificates data from the World Health Organization (WHO) mortality database. Methods We extracted country-level mortality data for pleural infection (International Classification of Diseases 10th Edition, ICD-10, codes “J86.0”, “J86.9”) from the WHO dataset. We calculated sex-specific age-standardised mortality rates for the quinquennia 2005–2009 and 2015–2019 using direct standardisation. Joinpoint regression analysis was used to assess temporal trends. Results Average yearly deaths approximately a 30% between 2005–2009 and 2015–2019. Mortality rates were 2.7-fold higher in males than females across both periods. The highest mortality rates in 2015–2019 were observed in South Africa (males 3.12; females 1.00 per 1 000 000), Argentina (males 2.61; females 1.09), and Brazil (males 3.05; females 1.21). Germany (AAPC +8.00% males; +5.57% females) and the USA (AAPC +3.55% females) demonstrated the greatest temporal increases, whereas France, Spain, and South Africa showed significant decreasing trends. Conclusion Pleural infection mortality rates remain low globally but demonstrate substantial international variation, consistent male predominance, and divergent temporal trends. These findings highlight the need for standardised case definitions and further investigation of factors underlying regional differences.