Years of life lost due to premature mortality in Italy
Years of life lost due to premature mortality in Italy
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DOI：
10.1023/a:1024635401206
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发表时间：
2003-01-01
影响因子：
13.6
通讯作者：
Freeman, K
中科院分区：
文献类型：
--
作者：
Mariotti, S;D'Errigo, P;Freeman, K
背景：疾病负担（BOD）的评估是合理分配有限的卫生相关资源的必要条件。意大利目前没有这种评估。研究方法：全球疾病负担（GBD）方法被用来详细分析1998年意大利导致过早死亡的最重要疾病的生命损失年（YLLs）组成部分。YLL的计算有和没有年龄加权和折扣。还按性别分析了意大利与2000年更新的GBD研究中定义的欧洲A区（一组26个欧洲国家）以及意大利北方、中部和南部这三个传统上划分的地区的YLL。结果如下：使用YLL可以根据疾病对死亡负担的相对贡献对疾病进行排序，这与纯粹基于死亡人数的排序不同。虽然男性和女性分别占YLL总死亡负担的58.5%和41.5%，但使用死亡计数，男性和女性的百分比相似（男性50.6%，女性49.4%）。在YLL和死亡计数方面，死亡负担的主要原因是缺血性心脏病，其次是中风和肺癌。然而，其他几个条件的排名根据所使用的衡量标准而有所不同。虽然心血管疾病占31.7%，“所有癌症”占34.1%，但它们分别占死亡人数的44.7%和27.9%。意大利的结果一般与2000年GBD欧洲-A获得的结果一致，但意大利由四个主要原因解释的总死亡率负担的比例较高。在意大利的比较中，“所有癌症”和几种特定癌症从北到南呈下降趋势。相反，中风和高血压疾病的YLL率从北到南一致增加。结论：对意大利死亡负担的分析是确定意大利总BOD的第一阶段。仅仅确定死亡人数和死亡率已不足以充分了解一个国家的卫生状况。
Background: The assessment of the burden of disease (BOD) is necessary for sensibly allocating limited health-related resources. No such assessment is available currently for Italy. Methods: Global burden of disease (GBD) methods were used to analyse in detail the years of life lost (YLLs) component of BOD for the most important diseases contributing to premature mortality in Italy in 1998. YLLs were computed with and without age-weighting and discounting. YLLs were also analysed by gender, for Italy vs. the Euro-A region (a group of 26 European countries) defined in the 2000 update of the GBD Study, and for northern, central and southern Italy, the three traditionally demarcated regions of the country. Results: The use of YLLs yields a ranking of diseases by their relative contribution to mortality burden which differs from a ranking based purely on death counts. Although males contributed 58.5% and females 41.5% of the total mortality burden in terms of YLLs, using death counts the percentages for males and females were similar (50.6% M, 49.4% F). The leading cause of mortality burden, both in terms of YLLs and death counts, was ischaemic heart disease, followed by stroke and lung cancer. Several other conditions, however, had rankings that varied depending on the measure used. While cardiovascular diseases accounted for 31.7% and 'all cancers' for 34.1% of YLLs, they were responsible, respectively, for 44.7 and 27.9% of death counts. The results for Italy generally corresponded with those obtained in GBD 2000 for EURO-A, but the proportion of the total mortality burden explained by the four leading causes is higher in Italy. For within Italy comparisons, there was a decreasing trend from north to south for 'all cancers' and for several specific cancers. Conversely, a consistent increase in YLL rates from north to south was observed for stroke and hypertensive disease. Conclusions: This analysis of Italy's mortality burden represents the first phase in identifying Italy's total BOD. Simply establishing death counts and rates is no longer sufficient for a full understanding of a country's health status.