Analysis of the disease burden and changing trends of road traffic injuries in Chinese population from 1990 to 2019
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摘要:
目的 分析1990―2019年中国人群道路交通伤害(road traffic injuries, RTIs)的疾病负担及变化趋势,为中国RTIs防控提出参考依据。 方法 利用2019年全球疾病负担(Global Burden of Disease 2019, GBD 2019)数据库,选取中国1990―2019年RTIs的死亡数、死亡率、伤残调整生命年(disability adjusted of life years, DALYs)、伤残损失寿命年(years lost due to disability, YLDs)、过早死亡损失寿命年(years of life lost, YLLs)、平均年度变化百分比(average annual percentage change, AAPC)、DALYs率、YLDs率、YLLs率等指标,利用Joinpoint模型分析1990―2019年中国人群RTIs的疾病负担及变化趋势。 结果 1990―2019年中国人群RTIs的死亡率(AAPC=-0.47%, P<0.001)、DALYs率(AAPC=-0.87%, P<0.001)、YLL率(AAPC=-1.47%, P<0.001)呈先升后降的趋势,YLDs率(AAPC=2.85%, P<0.001)则逐年增加。2019年中国人群RTIs死亡数为25.00万人,因RTIs造成的YLL占DALY的81.64%;男性的死亡数(率)、YLL数(率)为女性的3倍,YLD数、YLDs率亦高于女性。中国RTIs的死亡率、DALYs率以及YLLs率在0~14岁儿童均有所减轻。老年群体中死亡率、YLLs率在<65岁人群中呈下降趋势,DALYs率以60岁为界,在老年人口中呈上升趋势,YLDs率在各年龄段呈上升趋势。 结论 1990―2019年中国人群RTIs疾病负担总体呈下降趋势,但仍然面临着总体疾病负担较高、老年群体疾病负担加重、男性疾病负担远高于女性等问题,需进一步加强对RTIs的防治措施。 Abstract:Objective To analyze the changing trend of disease burden of road traffic injuries in Chinese population from 1990 to 2019, and to propose a basis for the prevention and control of road traffic injuries in China. Methods The Global Burden of Disease Database (GBD) was used to select the number of deaths, mortality rate, disability adjusted of life years (DALYs), years lost due to disability (YLDs), years of life lost (YLLs), average annual percentage change (AAPC), DALYs rate, YLDs rate, and YLLs rate of road traffic injuries in China from 1990 to 2019. Joinpoint models were used to analyze the disease burden of road traffic injuries in Chinese population and the trend of change from 1990 to 2019. Results The mortality rate (AAPC=-0.47%, P < 0.05), DALYs rate (AAPC=-0.87%, P < 0.05), and YLLs rate (AAPC=-1.47%, P < 0.05) of road traffic injuries in Chinese population from 1990 to 2019 showed a trend of increasing and then decreasing, while the YLDs rate (AAPC=2.85%, P < 0.05) increased year by year. The number of traffic injury deaths in Chinese population in 2019 was 25.00 thousand. YLLs due to road traffic injuries accounted for 81.64% of DALYs. The numbers of deaths (rate) and YLLs (rate) in men were three times higher than those in women, and the YLDs and YLDs rates were also significantly higher than those in women. In China, the road traffic death rate, DALYs rate and YLLs rate among children aged 0 to 14 have all shown a decrease. In the elderly population, the death rate and YLLs rate exhibited a upward trend in individuals above the age of 65, while the DALYs rate displayed an increasing trend in the elderly population up to the age of 60. Additionally, the YLDs rate demonstrated an upward trend across all age groups. Conclusions The overall trend of road traffic injury disease burden in China′s population from 1990 to 2019 is decreasing. However, the overall road traffic injury disease burden is still high. The road traffic injury disease burden is increasing in old age group. The road traffic injury disease burden is higher in men than that in women. The traffic injury prevention and control measures should be strengthened. -
Key words:
- Road traffic injuries /
- Burden of disease /
- Changing trends
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表 1 2019年中国人群RTIs的疾病负担现状
Table 1. Status of disease burden of road traffic injuries in Chinese in 2019
特征
Characteristics死亡数/万人
Number of death cases/×104死亡率/10万-1
Death rate/100 000-1DALYs/万人年
DALYs/104 yearsDALYs率/10万-1
DALYs rate/100 000-1YLDs/万人年
YLDs/104 yearsYLDs率/10万-1
YLDs rate/100 000-1YLLs/万人年
YLLs/104 yearsYLLs率/10万-1
YLLs rate/100 000-1性别Gender 男Male 18.65 25.72 965.65 1 332.26 177.00 244.20 788.65 1 088.06 女Female 6.36 9.11 360.12 516.28 118.88 170.43 241.24 345.85 年龄组/岁
Age groups/years0~<15 0.96 4.29 81.58 362.93 2.13 9.48 79.45 353.45 15~<20 0.67 8.89 50.06 666.22 2.43 32.35 47.63 633.87 20~<25 1.23 14.98 86.19 1 052.75 4.60 56.15 81.59 996.60 25~<30 1.60 14.45 108.21 977.35 9.70 87.59 98.51 889.76 30~<35 2.11 16.33 135.15 1 046.87 15.89 123.12 119.25 923.75 35~<40 1.86 18.39 112.05 1 110.53 16.30 161.51 95.75 949.02 40~<45 2.03 19.96 115.97 1 140.96 21.09 207.45 94.89 933.51 45~<50 2.31 19.01 127.71 1 052.27 31.06 255.95 96.64 796.30 50~<55 2.55 20.38 133.15 1 064.29 38.55 308.18 94.59 756.12 55~<60 2.08 21.96 102.05 1 076.06 34.54 364.15 67.52 711.92 60~<65 1.91 24.29 85.80 1 092.19 32.70 416.30 53.10 675.89 65~<70 1.89 26.83 76.53 1 087.32 32.51 461.88 44.02 625.44 70~<75 1.48 30.97 52.19 1 090.48 23.93 499.97 28.26 590.51 75~<80 1.01 33.75 30.35 1 016.96 15.16 508.03 15.19 508.94 ≥80 1.33 43.93 28.80 951.63 15.29 505.34 13.51 446.29 合计Total 25.00 17.58 1 325.77 932.10 295.88 208.02 1 029.89 724.08 注:RTIs, 道路交通伤害;DALYs:伤残调整生命年;YLDs:伤残损失寿命年;YLLs:过早死亡损失寿命年。
Note: RTIs, road traffic injuries; DALYs:disability adjusted of life year;YLDs:disability adjusted of life years;YLLs:years of life lost.表 2 1990―2019年中国人群RTIs的疾病负担变化情况
Table 2. Changes in the burden of disease from road traffic injuries in Chinese from 1990 to 2019
年份
Years死亡数/万人
Number of death cases/×104死亡率/10万-1
Death rate/100 000-1DALYs/万人年
DALYs/104 yearsDALYs率/10万-1
DALYs rate/100 000-1YLDs/万人年
YLDs/104 yearsYLDs率/10万-1
YLDs rate/100 000-1YLLs/万人年
YLLs/104 yearsYLLs率/10万-1
YLLs rate/100 000-11990 23.05 19.47 1 373.95 1 160.74 100.01 84.49 1 273.94 1 076.25 1991 22.69 18.93 1 351.16 1 127.35 101.63 84.80 1 249.53 1 042.55 1992 22.64 18.67 1 342.39 1 107.07 103.56 85.40 1 238.83 1 021.67 1993 22.74 18.55 1 340.00 1 093.17 105.80 86.31 1 234.20 1 006.86 1994 23.35 18.85 1 371.31 1 107.46 108.40 87.55 1 262.91 1 019.91 1995 24.08 19.26 1 408.25 1 126.58 111.24 88.99 1 297.01 1 037.60 1996 24.48 19.41 1 423.83 1 128.98 115.10 91.27 1 308.73 1 037.72 1997 24.88 19.56 1 439.48 1 131.86 120.16 94.48 1 319.32 1 037.38 1998 25.55 19.93 1 470.04 1 146.75 125.75 98.09 1 344.29 1 048.66 1999 26.45 20.48 1 507.71 1 167.41 131.28 101.65 1 376.43 1 065.76 2000 27.97 21.51 1 571.74 1 208.61 135.82 104.44 1 435.93 1 104.17 2001 29.14 22.27 1 613.98 1 233.21 139.22 106.37 1 474.77 1 126.84 2002 30.16 22.91 1 637.92 1 244.20 142.00 107.87 1 495.92 1 136.34 2003 31.30 23.65 1 668.26 1 260.50 144.80 109.40 1 523.47 1 151.09 2004 32.63 24.53 1 713.31 1 288.23 148.36 111.55 1 564.96 1 176.68 2005 32.85 24.59 1 708.57 1 278.84 153.33 114.76 1 555.24 1 164.08 2006 32.41 24.15 1 678.96 1 251.15 160.84 119.86 1 518.12 1 131.29 2007 32.42 24.05 1 675.23 1 242.92 170.50 126.50 1 504.74 1 116.42 2008 32.73 24.18 1 692.29 1 250.23 181.10 133.79 1 511.19 1 116.44 2009 32.92 24.22 1 705.13 1 254.52 191.52 140.91 1 513.62 1 113.61 2010 32.75 24.00 1 690.92 1 239.19 200.39 146.85 1 490.53 1 092.34 2011 31.58 23.06 1 622.96 1 184.82 208.68 152.35 1 414.28 1 032.47 2012 30.10 21.88 1 543.67 1 122.13 217.72 158.26 1 325.96 963.87 2013 28.89 20.91 1 488.86 1 077.40 226.98 164.25 1 261.88 913.15 2014 28.00 20.17 1 450.18 1 044.90 236.03 170.07 1 214.15 874.84 2015 26.90 19.29 1 396.50 1 001.39 244.22 175.12 1 152.29 826.27 2016 26.30 18.74 1 362.87 971.50 249.81 178.08 1 113.05 793.42 2017 25.71 18.22 1 336.58 947.38 256.76 182.00 1 079.82 765.39 2018 25.38 17.91 1 330.16 938.63 272.44 192.25 1 057.72 746.38 2019 25.00 17.58 1 325.77 932.10 295.88 208.02 1 029.89 724.08 AAPC/% -0.47 ① -0.87① 2.85 ① -1.47 ① 95% CI -0.69~-0.26 -1.15~-0.60 2.70~3.00 -1.75~-1.20 注:RTIs, 道路交通伤害; AAPC, 平均年度变化百分比; DALYs:伤残调整生命年;YLDs:伤残损失寿命年;YLLs:过早死亡损失寿命年。
① P<0.05。
Note: RTIs, road traffic injuries; AAPC, average annual percentage change; DALYs:disability adjusted of life year;YLDs:disability adjusted of life years;YLLs:years of life lost.
① P<0.05.表 3 1990―2019年中国人群RTIs的总体疾病负担
Table 3. AAPC in the comprehensive disease burden associated with RTIs within the Chinese population between 1990 and 2019
年龄组/岁
Age groups/years死亡率/10万-1
Death rate/100 000-1DALYs率/10万-1
DALYs rate/100 000-1YLDs率/10万-1
YLDs rate/100 000-1YLLs率/10万-1
YLLs rate/100 000-1AAPC值 95% CI AAPC值 95% CI AAPC值 95% CI AAPC值 95% CI 0~<15 -3.74 ① -4.13~-3.34 -3.71 ① -4.09~-3.32 1.15 ① 1.00~1.30 -3.77 ① -4.16~-3.37 15~<20 -1.49 ① -1.67~-1.30 -1.41① -1.58~-1.24 1.08 ① 0.87~1.28 -1.50 ① -1.68~-1.31 20~<25 -0.57 -1.18~0.04 -0.51 -1.10~0.09 1.20 ① 0.88~1.51 -0.57 -1.18 ~0.03 25~<30 -0.69 ① -1.36~-0.02 -0.45 -1.08~0.18 1.22 ① 1.04~1.39 -0.58 -1.15~0.10 30~<35 -0.81 -1.66~0.04 -0.65 -1.46~0.17 1.10 ① 0.93~1.26 -0.81 -1.66~0.04 35~<40 -1.21 ① -1.71~-0.70 -0.96 ① -1.45~-0.47 1.18 ① 0.96~1.39 -1.20 ① -1.71~-0.69 40~<45 -1.16 ① -1.48~-0.84 -0.85 ① -1.13~-0.56 1.24 ① 1.07~1.41 -1.20 ① -1.49~-0.90 45~<50 -1.05 ① -1.73~-0.37 -0.65 -1.31~-0.02 1.36 ① 1.05~1.68 -1.05 ① -1.73~-0.37 50~<55 -0.93 ① -1.30~-0.56 -0.38 ① -0.68~-0.07 1.51 ① 1.39~1.63 -0.93 ① -1.29~-0.57 55~<60 -0.77 ① -1.23~-0.30 -0.17 -0.58~0.23 1.61 ① 1.47~1.74 -0.77 ① -1.24~-0.30 60~<65 -0.14 -0.53~0.26 0.44 ① 0.19~0.70 1.74 ① 1.58~1.90 -0.14 -0.53~0.25 65~<70 0.04 -0.38~0.46 0.66 ① 0.16~1.16 1.96 ① 1.88~2.04 0.03 -0.39~0.45 70~<75 0.12 -0.09~0.34 0.91 ① 0.74~1.08 2.26 ① 2.16~2.38 0.17 -0.02~0.36 75~<80 0.08 -0.33~0.49 1.01 ① 0.69~1.34 2.28 ① 2.11~2.45 0.06 -0.34~0.47 ≥80 0.80 ① 0.48~1.11 1.32 ① 1.03~1.60 2.16 ① 1.93~2.40 0.63 ① 0.29~0.96 注:RTIs, 道路交通伤害; AAPC, 平均年度变化百分比; DALYs:伤残调整生命年;YLDs:伤残损失寿命年;YLLs:过早死亡损失寿命年。
① P<0.05。
Note: RTIs, road traffic injuries; AAPC, average annual percentage change; DALYs:disability adjusted of life year;YLDs:disability adjusted of life years;YLLs:years of life lost.
① P<0.05. -
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