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摘要:
目的 分析1990—2017年内蒙古自治区(内蒙古)人群跌倒的疾病负担变化,为制定跌倒预防控制策略提供参考。 方法 利用全球疾病负担2017研究结果,采用死亡数、死亡率、过早死亡损失寿命年(YLL)、YLL率、伤残损失寿命年(YLD)、YLD率、伤残调整寿命年(DALY)、DALY率等指标,利用2017年全球标准人口对各项率进行标化,描述内蒙古不同性别、年龄组人群跌倒的疾病负担情况,采用平均年度变化百分比(AAPC)反映跌倒疾病负担变化趋势。 结果 2017年内蒙古因跌倒造成的死亡数、YLD、DALY分别为854人、3.68万人年、6.34万人年,较1990年分别增加了32.53%、204.22%、37.98%, 而YLL下降了21.46%。1990—2017年标化死亡率由4.21/10万下降到3.23/10万,AAPC为−1.0%;标化DALY率由216.71/10万下降到208.10/10万,AAPC为−0.4%;标化YLL率由155.70/10万下降到97.53/10万,AAPC为−2.0%;标化YLD率呈现上升趋势,AAPC为2.20%,以上趋势变化均有统计学意义(P<0.05)。 男性的标化死亡率,标化YLL率、标化YLD率、标化DALY率均高于女性。 人群死亡率、YLL率、DALY率随年龄先下降后上升,在5~14岁年龄组最低,70岁以上年龄组最高。 与1990年相比,0~14岁人群因跌倒所致的死亡和疾病负担有所下降。 结论 1990—2017年内蒙古人群因跌倒所致标化死亡率和标化DALY率呈现下降趋势,但因跌倒导致的伤残疾病负担则上升,70岁以上老年人为重点人群;应采取有针对性的措施降低跌倒所致的死亡和疾病负担。 Abstract:Objective To analyze the disease burden of falls in Inner Mongolia from 1990 to 2017 and provide reference for the development of strategy of prevention and control of falls. Methods The number of deaths, mortality rate, years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs) of falls in Inner Mongolia during this period were from the results of the Global Burden of Disease study 2017 and standardized by using the 2017 global standard population. The gender and age specific disease burden of falls in Inner Mongolia during this period were described and the average annual percent change (AAPC) was used to reflect the change trend of disease burden of falls from 1990 to 2017. Results In 2017, the number of deaths , YLD, DALYs caused by falls in Inner Mongolia were 854, 36800 person years and 63400 person years respectively, which increased by 32.53%, 204.22% and 37.98% compared with 1990, however, the YLL fell by 21.46%; the standardized mortality rate decreased from 4.21/100 000 in 1990 to 3.23/100 000 in 2017, the AAPC was −1.00%, the standardized DALY rate decreased from 216.71/100 000 in 1990 to 208.10/100 000 in 2017, the AAPC was −0.40%, the standardized YLL rate decreased from 155.70/100 000 in 1990 to 97.53/100 000 in 2017, the AAPC was −2.00%, however, the standardized YLD rate showed an increase trend, the AAPC was 2.20%, all the above changes were statistically significant (P<0.05). The standardized mortality rate, the standardized YLL rate, the standardized YLD rate, the standardized DALY rate of falls were higher in men than in women. The mortality rate, YLL rate, and DALY rate declined first and then increased with age, the mortality rate, the YLL rate and the DALY rate was lowest in age group 5–14 years but highest in age group >70 years. Compared with 1990, the death number and disease burden of falls in age group 0–14 years showed decrease trends. Conclusion The standardized mortality rate and standardized DALY rate caused by falls showed decrease trends from 1990 to 2017, however, the burden of disability showed an increase trend. The elderly aged >70 years were the key population, it is necessary to take targeted prevention measures to reduce the death and disease burden of falls in this population. -
Key words:
- Fall /
- Burden of disease /
- Death /
- Disability-adjusted life years
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表 1 1990与2017年内蒙古不同性别人群跌倒疾病负担变化
Table 1. Gender specific disease burden of falls in Inner Mongolia, 1990 and 2017
男性 女性 合计 1990年 2017年 平均年度变化百分比(%) P值 95% CI 变化率(%) 1990年 2017年 平均年度变化百分比(%) P值 95% CI 变化率(%) 1990年 2017年 平均年度变化百分比(%) P值 95 %CI 变化率(%) 粗死亡率(/10万) 4.35 4.93 0.37 <0.001 0.2~0.6 13.33 1.19 1.53 0.82 <0.001 0.5~1.1 28.57 2.83 3.3 0.47 <0.001 0.2~0.7 16.61 标化死亡率(/10万) 5.99 4.73 −0.9 <0.001 −1~−0.9 −21.04 2.17 1.69 −0.9 <0.001 −1.1~−0.7 −22.12 4.21 3.23 −1 <0.001 −1.1~−0.9 −23.28 过早死亡损失寿命年(万人年) 2.67 0.47 − −16.69 0.72 0.44 −39.23 3.38 2.66 − −21.46 过早死亡标化损失寿命年率(/10万) 232.08 150.82 −1.8 <0.001 −1.9~−1.7 −35.01 71.52 39.73 −2.7 <0.001 −3~−2.3 −44.45 155.7 97.53 −2 <0.001 −2.1~−1.9 −37.51 伤残损失寿命年
(万人年)0.76 2.16 − 185.01 0.45 1.52 236.29 1.21 3.68 − 204.22 标化伤残损失寿命年率(/10万) 71.74 126.49 2.2 <0.001 1.9~2.5 76.32 49.07 93.18 2.1 <0.001 1.7~2.5 89.89 61.01 110.57 2.2 <0.001 1.9~2.5 81.23 伤残调整寿命年
(万人年)3.42 4.38 − 27.88 1.17 1.96 67.54 4.59 6.34 − 37.98 标化伤残调整寿命年率(/10万) 303.82 277.31 −0.5 <0.001 −0.7~−0.3 −8.73 120.59 132.91 −0.2 >0.05 −0.4~0.1 10.22 216.71 208.1 −0.4 <0.001 −0.6~−0.2 −3.97 注:−. 无数据 表 2 1990与2017年内蒙古不同性别、不同年龄组人群跌倒疾病负担变化情况
Table 2. Gender and age specific disease burden of falls in Inner Mongolia, 1990 and 2017
年龄组
(岁)死亡人数
(人)标化死亡率
(/10万)标化过早死亡损失
寿命年率(/10万)标化伤残损失
寿命年率(/10万)标化伤残调整
寿命年率(/10万)过早死亡损失寿命年占伤残调整寿命年
比例(%)男性 女性 合计 男性 女性 合计 男性 女性 合计 男性 女性 合计 男性 女性 合计 男性 女性 合计 0~4 1990年 74.50 43.74 118.25 5.40 3.49 4.49 465.51 300.42 386.88 4.95 3.61 4.31 470.46 304.03 391.20 98.95 98.81 98.90 2017年 19.03 7.89 26.92 2.84 1.35 2.84 244.59 116.42 184.92 11.44 8.00 9.84 256.02 124.42 194.76 95.53 93.57 94.95 变化率(%) −74.46 −81.96 −77.23 −47.41 −61.32 −36.75 −47.46 −61.25 −52.2 131.11 121.61 128.31 −45.58 −59.08 −50.21 −3.46 −5.30 −3.99 5~14 1990年 44.83 13.67 58.50 2.06 0.66 1.38 162.38 52.70 109.08 21.93 14.67 18.40 184.31 67.37 127.48 88.10 78.22 85.57 2017年 9.44 3.86 13.30 0.83 0.38 0.83 65.13 29.75 48.36 44.52 26.46 35.96 109.65 56.21 84.32 59.40 52.93 57.36 变化率(%) −78.94 −71.76 −77.26 −59.71 −42.42 −39.86 −59.89 −43.55 −55.67 103.01 80.37 95.43 −40.51 −16.57 −33.86 −32.58 −32.33 −32.97 15~49 1990年 233.22 26.61 259.82 3.53 0.43 2.03 196.59 23.83 112.98 72.46 45.59 59.46 269.05 69.42 172.44 73.07 34.33 65.52 2017年 225.05 19.62 244.66 3.03 0.29 3.03 149.67 14.60 85.80 138.23 92.47 116.59 287.90 107.07 202.39 51.99 13.63 42.39 变化率(%) −3.5 −26.27 −5.83 −14.16 −32.56 49.26 −23.87 −38.73 −24.06 90.77 102.83 96.08 7.01 54.24 17.37 −28.85 −60.30 −35.30 50~69 1990年 96.27 17.03 113.30 6.80 1.46 4.38 202.72 41.21 129.66 132.12 94.57 115.13 334.84 135.78 244.79 60.54 30.35 52.97 2017年 217.15 41.88 259.04 6.11 1.24 6.11 182.89 34.51 110.69 242.97 196.29 220.26 425.86 230.80 330.94 42.95 14.95 33.45 变化率(%) 125.56 145.92 128.63 −10.15 −15.07 39.5 −9.78 −16.26 −14.63 83.90 107.56 91.31 27.18 69.98 35.19 −29.06 −50.74 −36.85 70 1990年 66.34 28.43 94.77 24.42 12.99 19.32 316.12 159.24 246.13 133.83 115.94 125.85 449.95 275.17 371.98 70.26 57.87 66.17 2017年 193.84 116.54 310.38 27.27 15.00 27.27 314.73 158.66 233.23 294.40 277.26 285.45 609.13 435.92 518.68 51.67 36.40 44.97 变化率(%) 192.19 309.92 227.51 11.67 15.47 41.15 −0.44 −0.36 −5.24 119.98 139.14 126.82 35.38 58.42 39.44 −26.46 −21.47 −32.04 -
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