Disease burden of drowning among residents in Hubei province, 1990 – 2015
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摘要:
目的 了解1990年与2015年湖北省人群溺水的疾病负担及变化情况,为溺水的预防和控制工作提供参考依据。 方法 利用2015年全球疾病负担(GBD)研究结果,采用患病率、死亡率、伤残损失寿命年(YLD)、过早死亡损失寿命年(YLL)、伤残调整寿命年(DALY)等指标对1990年和2015年湖北省人群溺水的疾病负担状况进行描述;应用2015年GBD的标准人口对各指标进行标化,描述其疾病负担的变化情况。 结果 2015年与1990年比较,湖北省人群溺水患病数由1990年的7.86万例降至2015年的5.00万例(下降36.39 %),标化患病率由1990年的175.43/10万降至2015年的79.90/10万(下降54.45 %);死亡数由1990年的1.36万例降至2015年的0.38万例(下降72.06 %),标化死亡率由1990年的24.23/10万降至2015年的7.96/10万(下降67.15 %);湖北省人群溺水的YLD由1990年的0.57万人年降至2015年的0.22万人年(下降61.40 %),标化YLD率由1990年的12.33/10万降至2015年的3.55/10万(下降71.21 %);YLL由1990年的96.54万人年降至2015年的17.88万人年(下降81.48 %),标化YLL率由1990年的1 598.76/10万降至2015年的425.41/10万(下降73.39 %);DALY由1990年的97.11万人年降至2015年的18.10万人年(下降81.36 %),标化DALY率由1990年的1 611.09/10万降至2015年的428.96/10万(下降73.37 %)。不同年龄组人群中,1990年与2015年溺水患病率均以 ≥ 70岁老年人为最高(505.73/10万和331.62/10万);溺水死亡率1990年以 < 5岁儿童为最高(88.94/10万),2015年以 ≥ 70岁老年人为最高(21.39/10万);1990年和2015年YLL率、DALY率均以 < 5岁儿童为最高(7 526.43/10万和1 109.36/10万、7 528.24/10万和1 109.64/10万),YLD率均以 ≥ 70岁老年人为最高(28.99/10万和14.29/10万);2015年与1990年比较,2015年溺水患病率、死亡率、YLD率、YLL率和DALY率在各年龄段均有下降,其下降幅度随年龄增长而减少,其中 < 5岁儿童的下降幅度均最大。 结论 2015年较1990年湖北省人群溺水的疾病负担有所下降,溺水的疾病负担主要由早死所致,儿童、青少年和老年人仍是溺水关注的重点人群。 -
关键词:
- 溺水 /
- 疾病负担 /
- 伤残损失寿命年(YLD) /
- 过早死亡损失寿命年(YLL) /
- 伤残调整寿命年(DALY)
Abstract:Objective To examine the disease burden of drowning among residents in Hubei province during the period from 1990 through 2015 and to provide references for the prevention and control of drowning. Methods We extracted relevant data from the study results of Global Burden of Disease 2015 (GBD2015). Drowning-related mortality, years lived with disability (YLD), years of life lost due to premature mortality (YLL), and disability-adjusted life years (DALY) during the period from 1990 through 2015 were calculated for the population of Hubei province. The standard population of the 2015 GBD was used to adjust the indicators calculated. Results Among the residents in Hubei province, the annual number and incidence rate of drowning declined from 76 800 and 175.43/100 000 in 1990 to 50 000 and 79.90/100 000 in 2015, with the decrease rates of 36.39% for number of drowning and 54.45% for the incidence rate. During the 26-year period for the population of the province, the annual number of death and standardized mortality rate due to drowning decreased by 72.06% (from 13 600 to 3 800) and 67.15% (from 24.23/100 000 to 7.96/100 000); the YLD of drowning declined from 0.57 to 0.22 ten thousand person years (decreased by 61.40%) and the standardized YLD rate declined from 12.33/100 000 to 3.55/100 000 (decreased by 71.21%); the YLL of drowning declined from 96.54 to 17.88 ten thousand person years (decreased by 81.48%) and the standardized YLL rate declined from 1598.76/100 000 to 425.41/100 000 (decreased by 73.39%); the DALY of drowning declined from 97.11 to 18.10 ten thousand person years (decreased by 81.36%) and the standardized DALY rates declined from 1 611.09/100 000 to 428.96/100 000 (decreased by 73.39%). The annual incidence rate of drowning was the highest (505.73/100 000 in 1990 and 331.62/100 000 in 2015) among the residents aged ≥ 70 years compared to the residents of other ages; in 1990, the mortality rate of drowning was the highest (88.94/100 000) among the children of < 5 years old, but in 2015, the rate was the highest (21.39/100 000) among the elderly residents of ≥ 70 years old; in 1990 and 2015, both the YLL and DALY rate were the highest (7 526.43/100 000 and 1 109.36/100 000 in 1990 and 7 528.24/100 000 and 1 109.64/100 000 in 2015) among the elderly aged ≥ 70 years and the YLD rate were the highest (28.99/100 000 in 1990 and 14.29/100 000 in 2015) among the elderly aged ≥ 70 years. Compared with those in 1990, the incidence, mortality, YLD, YLL, and DALY rate of drowning declined in 2015 among the residents of all age groups and the declines were the highest for the children of < 5 years old; the decreases of the rates were inversely correlated with the increment of age of the residents. Conclusion The disease burden of drowning declined and was mainly attributed to premature deaths due to drowning among the residents in Hubei province during the period from 1990 through 2015. The populations with higher disease burden of drowning are children, adolescents, and the elderly. -
表 1 1990年与2015年湖北省人群溺水患病和死亡变化情况
性别 患病数(万例) 标化患病率(1/10万) 死亡数(万例) 标化死亡率(1/10万) 男性 1990年 4.94(4.18~5.79) 210.53(183.01~242.23) 0.89(0.65~1.18) 30.50(23.07~39.80) 2015年 3.13(2.81~3.51) 99.78(89.63~111.65) 0.26(0.20~0.33) 10.41(8.24~13.01) 变化率(%) – 36.64 – 52.61 – 70.79 – 65.87 女性 1990年 2.92(2.54~3.36) 138.43(122.99~157.02) 0.47(0.18~0.69) 17.59(6.76~25.29) 2015年 1.87(1.68~2.09) 59.59(53.62~66.23) 0.12(0.04~0.17) 5.15(1.84~6.96) 变化率(%) – 35.96 – 56.95 – 74.47 – 70.72 合计 1990年 7.86(6.74~9.15) 175.43(153.29~199.56) 1.36(0.99~1.78) 24.23(17.76~31.01) 2015年 5.00(4.49~5.59) 79.90(71.98~89.30) 0.38(0.28~0.46) 7.96(6.08~9.71) 变化率(%) – 36.39 – 54.45 – 72.06 – 67.15 注:括号内数据表示95 % UI。 表 2 1990年与2015年湖北省人群溺水疾病负担变化情况
性别 YLD(万人年) 标化YLD率(1/10万) YLL(万人年) 标化YLL率(1/10万) DALY(万人年) 标化DALY率(1/10万) 男性 1990年 0.36
(0.25~0.49)14.60
(10.21~19.96)63.4
(45.35~87.74)2 037.23
(1 485.24~2 770.33)63.76
(45.64~88.17)2 051.83
(1 497.86~2 787.60)2015年 0.14
(0.09~0.19)4.33
(2.91~6.06)12.96
(9.85~16.68)576.88
(442.08~742.69)13.09
(9.99~16.82)581.21
(446.03~746.82)变化率(%) – 62.11 – 70.34 – 79.56 – 71.68 – 79.47 – 71.67 女性 1990年 0.22
(0.15~0.30)9.93
(6.94~13.41)33.13
(11.65~50.73)1 133.28
(411.52~1 695.73)33.35
(11.85~50.92)1 143.21
(421.65~1 704.48)2015年 0.08
(0.06~0.12)2.74
(1.83~3.89)4.92
(1.83~6.79)248.39
(95.96~347.82)5.00
(1.90~6.90)251.14
(98.78~350.45)变化率(%) – 63.64 – 72.41 – 85.15 – 78.08 – 85.00 – 78.03 合计 1990年 0.57
(0.40~0.80)12.33
(8.66~16.67)96.54
(67.85~132.19)1 598.76
(1 138.85~2 145.72)97.11
(68.45~132.69)1 611.09
(1 152.07~2 156.71)2015年 0.22
(0.15~0.31)3.55
(2.37~4.96)17.88
(13.83~22.36)425.41
(329.74~528.09)18.10
(14.06~22.56)428.96
(332.61~531.49)变化率(%) – 61.40 – 71.21 – 81.48 – 73.39 – 81.36 – 73.37 注:括号内数据表示95 % UI。 表 3 1990年与2015年湖北省不同年龄组人群溺水患病率、死亡率和疾病负担变化情况
年龄(岁) 患病率(1/10万) 死亡率(1/10万) YLD率(1/10万) YLL率(1/10万) DALY率(1/10万) < 5 1990年 21.98
(16.71~30.53)88.94
(41.06~161.23)1.81
(1.17~2.75)7 526.43
(3 474.28~13 626.28)7 528.24
(3 476.00~13 628.04)2015年 4.60
(3.50~6.31)13.15
(6.34~22.87)0.28
(0.18~0.42)1 109.36
(534.41~1 927.47)1 109.64
(534.61~1 927.76)变化率(%) – 79.07 – 85.21 – 84.53 – 85.26 – 85.26 5~14 1990年 70.98
(54.07~90.45)41.43
(32.28~51.28)5.57
(3.62~8.19)3 204.99
(2 493.58~3 965.57)3 210.57
(2 498.37~3 970.96)2015年 20.00
(15.49~25.41)11.19
(8.59~14.45)0.99
(0.66~1.45)859.46
(659.07~1 110.81)860.45
(660.07~1 111.73)变化率(%) – 71.82 – 72.99 – 82.23 – 73.18 – 73.20 15~49 1990年 142.98
(119.81~170.21)10.36
(7.72~13.55)10.97
(7.54~15.24)617.36
(462.29~806.30)628.33
(474.33~814.38)2015年 61.35
(52.94~70.89)4.41
(3.33~5.79)2.73
(1.78~3.87)248.17
(188.02~327.48)250.89
(190.96~330.76)变化率(%) – 57.09 – 57.43 – 75.14 – 59.80 – 60.07 50~69 1990年 284.66
(247.55~322.44)11.84
(8.09~15.54)19.73
(13.83~26.70)336.04
(227.66~441.07)355.77
(247.10~463.81)2015年 137.90
(122.01~155.03)5.80
(4.09~7.53)6.13
(4.08~8.74)161.96
(114.99~210.09)168.09
(120.06~215.94)变化率(%) – 51.56 – 51.01 – 68.93 – 51.80 – 52.75 ≥ 70 1990年 505.73
(452.71~569.62)26.89
(16.58~35.89)28.99
(20.55~39.44)369.03
(227.66~496.21)398.02
(254.50~525.75)2015年 331.62
(293.90~377.57)21.39
(12.76~27.54)14.29
(9.67~20.15)240.98
(149.29~311.85)255.27
(162.72~325.81)变化率(%) – 34.43 – 20.45 – 50.71 – 34.70 – 35.87 注:括号内数据表示95 % UI。 -
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