2014—2018年四川省伤害死亡变化趋势及早死分析

Analysis on the trend of injury mortality and premature mortality in Sichuan Province during 2014-2018

目的 了解2014—2018年四川省伤害死亡趋势及其导致的早死情况,为制定伤害防控策略提供依据。方法 死亡信息资料来源于中国疾病预防控制信息系统人口死亡信息登记管理系统,选取2014—2018年四川省31个国家级死因监测点死亡日期为2014年1月1日至2018年12月31日的全部常住居民死亡个案。根据《国际疾病分类第十次修订本》(ICD-10)进行疾病分类。采用SAS 9.4软件进行统计分析,计算各年度伤害死亡率、标化死亡率以及过早死亡损失寿命年(YLL),采用年度变化百分比(APC)对死亡率年均变化情况进行描述。结果 2014—2018年四川省因伤害死亡46 302例,占死亡总数的7.71%,死亡率为53.74/10万,标化死亡率为47.95/10万。居民伤害死亡前5位死因分别为道路交通伤害(28.05%)、意外跌落(27.77%)、自杀(12.76%)、溺水(10.29%)和意外中毒(6.31%),占伤害死亡总数的85.18%。分性别伤害死因中,男女性首位伤害死因分别为道路交通伤害和意外跌落。年龄别伤害死因中,0~4岁组前5位死因为溺水、意外窒息、道路交通伤害、意外跌落和意外中毒;5~14岁组分别为溺水、道路交通伤害、意外跌落、自杀和意外中毒;15~44岁组分别为道路交通伤害、意外跌落、自杀、意外中毒和溺水;45~64岁组分别为道路交通伤害、意外跌落、自杀、溺水和意外中毒;65岁及以上组分别为意外跌落、道路交通伤害、自杀、溺水和意外中毒。2014—2018年四川省道路交通伤害的YLL率呈下降趋势(P<0.05),一直位居第1位;意外跌落位居第2位,呈上升趋势(P<0.05)。伤害YLL率由2014年的20.43‰下降到2018年的17.74‰,下降趋势有统计学意义(P<0.05)。结论 伤害死亡是导致居民早死的重要原因,道路交通伤害是伤害导致早死的首位原因,应根据不同性别、不同年龄组人群的伤害特征有针对性地采取干预措施,以有效降低伤害的疾病负担。

Objective To understand the trend of injury mortality and premature mortality in Sichuan Province from 2014 to 2018,and provide the basis for formulating the injury prevention and control strategy. Methods The death data were from China’s disease prevention and control information system-population death information registration management system. All death cases of permanent residents at 31 national death cause monitoring points in Sichuan Province from 2014 to 2018 with death dates from January 1,2014 to December 31,2018 were selected as the subjects. The annual injury mortality,standardized mortality,and the years of life lost due to premature mortality(YLL) according to the ICD-10 disease classification were calculated. The annual percent change(APC) was used to describe the annual average change of mortality. The used software was SAS 9.4. Results From2014 to 2018,there were 46 320 injury-related deaths in Sichuan Province,accounting for 7.71% of the total deaths,the mortality was 53.74/105 and the standardized mortality was 47.95/105. The top five rank order of injury death causes in residents were the traffic accidents(28.05%),accidental falls(27.77%),suicide(12.76%),drowning(10.29%) and accidental poisoning(6.31%),accounting for 85.18% of the total injury deaths. Among the death causes of sex-specific injury, the first death causes of males and females were the traffic accidents and accidental falls. Among the death causes of age-specific injury,the top five causes of death in the 0-4 years old group were drowning,accidental mechanical asphyxia,traffic accidents,accidental falls and accidental poisoning;the top five causes of death in the 5-14 years old group were drowning,the traffic accidents,accidental falls,suicide and accidental poisoning;the top five causes of death in the 15-44 years old group were the traffic accidents,accidental falls,suicide,accidental poisoning and drowning;the top five causes of death in the 45-64 years old group were the traffic accidents,accidental falls,suicide,drowning and accidental poisoning;the top five causes of death in the ≥65 years old group were the accidental falls,traffic accidents,suicide,drowning and accidental poisoning. The YLL rate of road traffic injuries in Sichuan Province showed a downward trend from 2014 to 2018(P<0.05),but it has always ranked the first;accidental falls ranked the second and showed an upward trend(P<0.05);the total YLL rate of injuries decreased from 20.43‰ in 2014 to 17.74‰ in 2018(P<0.05). Conclusion Injury death is an important cause of early death of residents in Sichuan Province. Road traffic accident is the important cause of early death due to injuries. The intervention measures should be taken to effectively reduce the disease burden caused by injuries,according to the characteristics of different age and sex groups.