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中国居民1990 - 2019年伤害疾病负担变化趋势及预测分析

Burden of disease from injury among Chinese residents – change trend from 1990 to 2019 and change predicted for 2020 – 2025 : a GBD 2019 based analysis

  • 摘要:
    目的 分析中国居民1990 — 2019年伤害疾病负担变化趋势并对2020 — 2025年伤害的标化发生率、标化死亡率和标化伤残调整寿命年(DALY)率进行预测,为我国居民伤害的预防控制提供参考依据。
    方法 收集2019年全球疾病负担(GBD 2019)研究中1990 — 2019年中国、亚洲和全球居民伤害疾病负担的相关数据,采用发生率、标化发生率、死亡率、标化死亡率、伤残寿命损失年(YLD)率、标化YLD率、死亡寿命损失年(YLL)率、标化YLL率、DALY率和标化DALY率等指标进行描述性分析,采用Joinpoint回归模型分析中国居民1990 — 2019年中国、亚洲和全球居民伤害疾病负担指标的平均年度变化百分比(AAPC),并应用构建求和自回归移动平均(ARIMA)模型预测中国居民2020 — 2025年伤害的标化发生率、标化死亡率和标化DALY率。
    结果 中国居民1990 — 2019年伤害发生率、标化发生率、YLD率和标化YLD率分别从1990年的5976.31/10万、5863.81/10万、461.57/10万和511.58/10万上升至2019年的6328.60/10万、6138.73/10万、679.01/10万和534.88/10万,总变化率分别为5.89%、4.69%、47.11%和4.56%,增幅均高于亚洲和全球居民;中国居民1990 — 2019年伤害死亡率、标化死亡率、YLL率、标化YLL率、DALY率和标化DALY率分别从1990年的74.34/10万、83.03/10万、4215.54/10万、4204.05/10万、4677.11/10万和4715.63/10万上升至2019年的49.67/10万、44.20/10万、1825.22/10万、1787.50/10万、2504.23/10万和2322.38/10万,总变化率分别为 – 33.19%、– 46.76%、– 56.70%、– 57.48%、– 46.46%和 – 50.75%,降幅均高于亚洲和全球居民;Joinpoint回归模型分析结果显示,中国居民1990 — 2019年伤害标化发生率和标化YLD率总体均呈上升趋势(AAPC = 0.15%,P = 0.006),伤害标化死亡率、标化YLL率和标化DALY率总体均呈下降趋势(AAPC = – 2.28%、– 2.62%和 – 3.07%,均P < 0.01);1990年和2019年居于中国居民伤害疾病负担首位的伤害类型均为道路伤害,DALY分别为1373.95万人年和1325.77万人年,标化DALY率分别为1232.72/10万和859.58/10万;中国居民2020 — 2025年伤害预测标化发生率为6293.79/10万~6492.15/10万,预测标化死亡率为41.50/10万 ~ 48.38/10万,预测标化DALY率为1850.11/10万~2234.51/10万,2020 — 2025年伤害预测标化发生率持续上升,而预测标化死亡率和预测标化DALY率均持续下降(均P < 0.05)。
    结论 中国居民1990 — 2019年伤害标化发生率和标化YLD率总体均呈上升趋势,而标化死亡率、标化YLL率和标化DALY率总体均呈下降趋势;2020 — 2025年伤害预测标化发生率持续上升,而预测标化死亡率和预测标化DALY率均持续下降。

     

    Abstract:
    Objective To analyze the change trend of the disease burden of injuries among Chinese residents from 1990 to 2019, and to predict the age-standardized incidence, mortality, and disability-adjusted life-years (DALY) rates of injuries from 2020 to 2025, providing a reference for the prevention and control of injuries among the Chinese population.
    Methods Data on the disease burden of injury in populations in China, Asia, and the world from 1990 to 2019 were collected from the Global Burden of Disease Study – 2019 (GBD 2019). Crude and age-standardized rates of incidence, mortality, years lived with disability (YLD), years of life lost (YLL), and DALY of injury were used in the descriptive analysis. A joint-point regression model was constructed to analyze the average annual percentage change (AAPC) in these rates between 1990 and 2019. In addition, an autoregressive integrated moving average (ARIMA) model was constructed to predict the standardized rates of incidence, mortality, and DALY of injury from 2020 to 2025 in the Chinese population.
    Results From 1990 to 2019, increases in the crude and age-standardized rates (1/100 000) of injury incidence (5 976.31 to 6 328.60 and 5 863.81 to 6 138.73) and YLD (461.57 to 679.01 and 511.58 to 534.88) were observed in the Chinese population, with overall rate increases of 5. 89%, 4.69%, 47.11%, and 4.56%, respectively, and the rate increases were all higher than those in the Asian and global populations; however, decreases in the crude and age-standardized rates were observed for injury mortality (74. 34 to 49.67 and 83.03 to 44.20), YLL (4215.54 to 1825.22 and 4204.05 to 1787.50), and DALY (4677.11 to 2504.23 and 4715.63 to 2322.38), with overall decreases of – 33.19%, – 46.76%, – 56.70%, – 57.48%, – 46.46%, and – 50.75%, respectively, and the rate decreases were all greater than those in the Asian and global populations. The results of Joinpoint regression model analysis show that from 1990 to 2019, the age-standardized incidence and YLD rate of injuries in the Chinese population showed an overall increasing trend (AAPC = 0.15%, P = 0.006), while the age-standardized mortality, YLL, and DALY rate of injuries showed an overall decreasing trend (AAPC = – 2.28%, – 2.62%, and – 3.07%, all P < 0.01). The injury type that ranked first in terms of injury disease burden in the Chinese population in 1990 and 2019 was road traffic injuries, with DALYs of 13.73957 million person-years and 13.2577 million person-years, and the age-standardized DALY rates (1/100 000) of 12.327 2 and 8.595 8, respectively. For the Chinese population between 2020 and 2025, the predicted age-standardized injury incidence rate (1/100 000) ranges from 6 293.79 to 6 492.15; the predicted age-standardized mortality rate (1/100 000) ranges from 41.50 to 48.38; and the predicted age-standardized DALY rate (1/100 000) ranges from 1 850.11 to 2 234.510. The predicted age-standardized injury incidence rate for 2020 – 2025 is expected to continue to increase, while the predicted age-standardized mortality and DALY rates are expected to continue to decrease (all P < 0.05).
    Conclusion The age-standardized incidence and YLD rates of injuries in the Chinese population showed an overall increasing trend from 1990 to 2019, while the age-standardized mortality, YLL, and DALY rates showed an overall decreasing trend. From 2020 to 2025, the age-standardized incidence rate of injuries will continue to increase, while the age-standardized mortality rate and DALY rate will continue to decrease.

     

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