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Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017.
The BMJ ( IF 105.7 ) Pub Date : 2020-02-19 , DOI: 10.1136/bmj.m234
Xiaochen Li 1, 2 , Xiaopei Cao 1, 2 , Mingzhou Guo 1, 2 , Min Xie 2, 3 , Xiansheng Liu 1, 2
Affiliation  

OBJECTIVE To describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017. DESIGN Systematic analysis. DATA SOURCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2017. METHODS Mortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data. RESULTS Between 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma. CONCLUSIONS Regions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.

中文翻译:

1990年至2017年慢性呼吸道疾病死亡率和残疾调整生命年的趋势和危险因素:《 2017年全球疾病负担研究》的系统分析。

目的使用“ 2017年全球疾病负担研究”中的数据,按年龄和性别描述世界范围内按年龄和性别分类的由慢性呼吸道疾病引起的死亡率和残疾调整生命年(DALYs)的时空趋势。设计系统分析。数据来源《 2017年全球疾病,伤害和危险因素负担研究》。方法根据《 2017年全球疾病负担研究》,使用贝叶斯meta回归工具DisMod-MR 2.1对慢性呼吸道疾病的死亡率和DALY进行了估算。使用具有高斯分布的广义线性模型计算了年龄标准化死亡率的估计年度变化百分比。根据社会人口统计学指标对死亡率和DALY进行分层。社会人口统计学指标与死亡率之间联系的强度和方向使用Spearman等级顺序相关性进行了测量。从暴露数据分析了慢性呼吸系统疾病的危险因素。结果1990年至2017年,慢性呼吸道疾病致死总数从1990年的3.32(95%不确定区间3.01至3.43)百万增加到2017年的3.91(3.79至4.04)百万,增长了18.0%。年龄标准化死亡率慢性呼吸道疾病平均每年减少2.41%(2.28%至2.55%)。在过去的27年中,慢性阻塞性肺疾病(COPD; 2.36%,不确定区间为2.21%至2.50%)和尘肺病(2.56%,2.44%至2.68%)的死亡率每年下降缓慢,间质性肺疾病和肺结节病的死亡率增加了(0.97%,0.92%至1.03%)。哮喘和尘肺病的DALYs有所减少,但COPD,间质性肺病和肺结节病引起的DALYs有所增加。在195个国家中,由于慢性呼吸道疾病引起的死亡率和死亡率的年度变化差异很大。评估造成27年来死亡率和DALYs区域差异的因素以及改善的不均等分布,表明社会人口统计学指数与COPD,尘肺和哮喘的死亡率呈负相关。社会人口指数低的地区死亡率和DALYs最高。吸烟仍然是导致COPD和哮喘死亡的主要危险因素。在社会人口指数较低的地区,颗粒物造成的污染是造成COPD死亡的主要原因。自2013年以来,高体重指数已成为哮喘的主要危险因素。结论社会人口统计学指标低的地区疾病负担最大。估计的危险因素(例如吸烟,环境污染和高体重指数)对死亡率和DALYs的贡献表明,需要采取紧急措施来减少对其的暴露。
更新日期:2020-02-20
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