1990年与2017年中国内地及港澳地区人群跌倒疾病负担分析

Analysis on Disease Burden of Falls in China's Mainland,Hong Kong and Macao’s Population in 1990 and 2017

目的分析1990年和2017年中国内地及港澳地区人群跌倒的疾病负担变化。方法利用2017年全球疾病负担(GBD)研究结果,采用死亡率、伤残调整寿命年(DALY)、过早死亡损失寿命年(YLL)和伤残损失寿命年(YLD)等指标,描述2017年中国内地及港澳地区不同性别、年龄组和省份人群跌倒的疾病负担现状。计算1990年与2017年疾病负担相关指标,并分析2017年中国内地及港澳地区人群较1990年跌倒疾病负担的变化。结果2017年中国内地及港澳地区人群因跌倒导致的死亡数和标化死亡率分别为13.48万和8.64/10万,较1990年分别增加了110.30%和12.79%;DALY标化率和YLD标化率分别上升到363.09/10万和154.02/10万,升幅为3.82%和67.56%,只有YLL标化率由1990年的257.81/10万下降至209.07/10万,下降幅度18.91%;男、女性的疾病负担指标DALY、YLL和YLD较1990年均有所增加;男、女性跌倒的死亡率和DALY率均随年龄增长呈先下降后上升的趋势,5~14岁年龄组人群最低,而70岁及以上年龄组最高,仅70岁及以上年龄组男性死亡数和死亡率低于女性,其他年龄组男性均高于女性;福建、云南和浙江的标化死亡率和DALY标化率均明显高于其他省份,东北三省相对较低。结论2017年中国内地及港澳地区人群跌倒造成的疾病负担仍然较重,尤其以老年人群为高危人群。不同性别、年龄组、省份人群跌倒导致的疾病负担不完全相同,采取有针对性的综合防控措施来降低跌倒带来的死亡和疾病负担十分重要。

Objective To analyze the status and trend of the disease burden of falls in China's Mainland,Hong Kong and Macao’s population in 1990 and 2017.Methods Indicators including mortality rate,disability-adjusted of life years(DALY),years of life lost(YLL),years lived with disability(YLD)on falls,were from the research results of the Global Burden of Disease 2017(GBD 2017).We used these indicators to describe the status of the disease burden caused by falls in different genders,age groups and provinces in China's Mainland,Hong Kong and Macao’s and analysis the percentage change on 1990 and 2017.Results In 2017,a total of 134800 people died of falls and the age standardized mortality rate was 8.64/100000(increased by 110.30%and 12.79%compared with data in 1990).In 2017,the age standardized DALY rate reached 363.09/100000 and the YLD rate reached to 154.02/100000(increased by 3.82%and 67.56%).Only the standardized YLL rate decreased from 257.81/100000 to 209.07/100000(decreased by 18.91%).Compared with the data in 1990,parameters such as DALY,YLL and YLD of falls are all increased.Alone with the increase in age,the mortality rate and DALY rate of falls showed a trend of decline first and then rise.Children aged 5~14 years had the lowest mortality rate and the DALY rate of falls while the elderly aged 70-year-old and above had the highest ones.Unlike other age groups,only death number and mortality rate of male for 70-year-old are lower than female.The standardized mortality rate and DALY standardized rate in Fujian,Yunnan and Zhejiang are significantly higher than those in other provinces,while the three northeastern provinces are relatively low.Conclusions In 2017,the disease burden caused by falls in China's Mainland,Hong Kong and Macao’s population is still heavy,especially for the elderly.There are differences in disease burden caused by falls among different genders,age groups and provinces.Targeted prevention and control measures for falls are of great importance to decrease the death and burden of disease.