Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
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DOI：
10.1016/s0140-6736(14)61682-2
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发表时间：
2015-01-10
期刊：
影响因子：
168.9
通讯作者：
Murray, Christopher J. L.
中科院分区：
文献类型：
--
作者：
Naghavi, Mohsen;Wang, Haidong;Lozano, Rafael;Davis, Adrian;Liang, Xiaofeng;Zhou, Maigeng;Vollset, Stein Emil;Ozgoren, Ayse Abbasoglu;Abdalla, Safa;Abd-Allah, Foad;Aziz, Muna I. Abdel;Abera, Semaw Ferede;Aboyans, Victor;Abraham, Biju;Abraham, Jerry P.;Abuabara, Katrina E.;Abubakar, Ibrahim;Abu-Raddad, Laith J.;Abu-Rmeileh, Niveen M. E.;Achoki, Tom;Adelekan, Ademola;Ademi, Zanfi Na;Adofo, Koranteng;Adou, Arsene Kouablan;Adsuar, Jose C.;Arnlov, Johan;Agardh, Emilie Elisabet;Akena, Dickens;Al Khabouri, Mazin J.;Alasfoor, Deena;Albittar, Mohammed;Alegretti, Miguel Angel;Aleman, Alicia V.;Alemu, Zewdie Aderaw;Alfonso-Cristancho, Rafael;Alhabib, Samia;Ali, Mohammed K.;Ali, Raghib;Alla, Francois;Al Lami, Faris;Allebeck, Peter;AlMazroa, Mohammad A.;Salman, Rustam Al-Shahi;Alsharif, Ubai;Alvarez, Elena;Alviz-Guzman, Nelson;Amankwaa, Adansi A.;Amare, Azmeraw T.;Ameli, Omid;Amini, Hassan;Ammar, Walid;Anderson, H. Ross;Anderson, Benjamin O.;Antonio, Carl Abelardo T.;Anwari, Palwasha;Apfel, Henry;Cunningham, Solveig Argeseanu;Arsenijevic, Valentina S. Arsic;Al Artaman;Asad, Majed Masoud;Asghar, Rana J.;Assadi, Reza;Atkins, Lydia S.;Atkinson, Charles;Badawi, Alaa;Bahit, Maria C.;Bakfalouni, Talal;Balakrishnan, Kalpana;Balalla, Shivanthi;Banerjee, Amitava;Barber, Ryan M.;Barker-Collo, Suzanne L.;Barquera, Simon;Barregard, Lars;Barrero, Lope H.;Barrientos-Gutierrez, Tonatiuh;Basu, Arindam;Basu, Sanjay;Basulaiman, Mohammed Omar;Beardsley, Justin;Bedi, Neeraj;Beghi, Ettore;Bekele, Tolesa;Bell, Michelle L.;Benjet, Corina;Bennett, Derrick A.;Bensenor, Isabela M.;Benzian, Habib;Bertozzi-Villa, Amelia;Beyene, Tariku Jibat;Bhala, Neeraj;Bhalla, Ashish;Bhutta, Zulfiqar A.;Bikbov, Boris;Bin Abdulhak, Aref;Biryukov, Stan;Blore, Jed D.;Blyth, Fiona M.;Bohensky, Megan A.;Borges, Guilherme;Bose, Dipan;Boufous, Soufiane;Bourne, Rupert R.;Boyers, Lindsay N.;Brainin, Michael;Brauer, Michael;Brayne, Carol E. G.;Brazinova, Alexandra;Breitborde, Nicholas;Brenner, Hermann;Briggs, Adam D. M.;Brown, Jonathan C.;Brugha, Traolach S.;Buckle, Geoffrey C.;Bui, Linh Ngoc;Bukhman, Gene;Burch, Michael;Nonato, Ismael Ricardo Campos;Carabin, Helesne;Cardenas, Rosario;Carapetis, Jonathan;Carpenter, David O.;Caso, Valeria;Castaneda-Orjuela, Carlos A.;Castro, Ruben Estanislao;Catala-Lopez, Ferrn;Cavalleri, Fiorella;Chang, Jung-Chen;Charlson, Fiona C.;Che, Xuan;Chen, Honglei;Chen, Yingyao;Chen, Jian Sheng;Chen, Zhengming;Chiang, Peggy Pei-Chia;Chimed-Ochir, Odgerel;Chowdhury, Rajiv;Christensen, Hanne;Christophi, Costas A.;Chuang, Ting-Wu;Chugh, Sumeet S.;Cirillo, Massimo;Coates, Matthew M.;Coffeng, Luc Edgar;Coggeshall, Megan S.;Cohen, Aaron;Colistro, Valentina;Colquhoun, Samantha M.;Colomar, Mercedes;Cooper, Leslie Trumbull;Cooper, Cyrus;Coppola, Luis M.;Cortinovis, Monica;Courville, Karen;Cowie, Benjamin C.;Criqui, Michael H.;Crump, John A.;Cuevas-Nasu, Lucia;Leite, Iuri da Costa;Dabhadkar, Kaustubh C.;Dandona, Lalit;Dandona, Rakhi;Dansereau, Emily;Dargan, Paul I.;Dayama, Anand;De la Cruz-Gongora, Vanessa;de la Vega, Shelley F.;De Leo, Diego;Degenhardt, Louisa;del Pozo-Cruz, Borja;Dellavalle, Robert P.;Deribe, Kebede;Jarlais, Don C. Des;Dessalegn, Muluken;deVeber, Gabrielle A.;Dharmaratne, Samath D.;Dherani, Mukesh;Diaz-Ortega, Jose-Luis;Diaz-Torne, Cesar;Dicker, Daniel;Ding, Eric L.;Dokova, Klara;Dorsey, E. Ray;Driscoll, Tim R.;Duan, Leilei;Duber, Herbert C.;Durrani, Adnan M.;Ebel, Beth E.;Edmond, Karen M.;Ellenbogen, Richard G.;Elshrek, Yousef;Ermakov, Sergey Petrovich;Erskine, Holly E.;Eshrati, Babak;Esteghamati, Alireza;Estep, Kara;Fuerst, Thomas;Fahimi, Saman;Fahrion, Anna S.;Faraon, Emerito Jose A.;Farzadfar, Farshad;Fay, Derek F. J.;Feigl, Andrea B.;Feigin, Valery L.;Felicio, Manuela Mendonca;Fereshtehnejad, Seyed-Mohammad;Fernandes, Jefferson G.;Ferrari, Alize J.;Fleming, Thomas D.;Foigt, Nataliya;Foreman, Kyle;Forouzanfar, Mohammad H.;Fowkes, F. Gerry R.;Fra Paleo, Urbano;Franklin, Richard C.;Futran, Neal D.;Gaffikin, Lynne;Gambashidze, Ketevan;Gankpe, Fortune Gbetoho;Garcia-Guerra, Francisco Armando;Garcia, Ana Cristina;Geleijnse, Johanna M.;Gessner, Bradford D.;Gibney, Katherine B.;Gillum, Richard F.;Gilmour, Stuart;Abdelmageem, Ibrahim;Ginawi, Mohamed;Giroud, Maurice;Glaser, Elizabeth L.;Goenka, Shifalika;Dantes, Hector Gomez;Gona, Philimon;Gonzalez-Medina, Diego;Guinovart, Caterina;Gupta, Rahul;Gupta, Rajeev;Gosselin, Richard A.;Gotay, Carolyn C.;Goto, Atsushi;Gowda, Hube N.;Graetz, Nicholas;Greenwell, K. Fern;Gugnani, Harish Chander;Gunnell, David;Gutierrez, Reyna A.;Haagsma, Juanita;Hafezi-Nejad, Nima;Hagan, Holly;Hagstromer, Maria;Halasa, Yara A.;Hamadeh, Randah Ribhi;Hamavid, Hannah;Hammami, Mouhanad;Hancock, Jamie;Hankey, Graeme J.;Hansen, Gillian M.;Harb, Hilda L.;Harewood, Heather;Haro, Josep Maria;Havmoeller, Rasmus;Hay, Roderick J.;Hay, Simon I.;Hedayati, Mohammad T.;Pi, Ileana B. Heredia;Heuton, Kyle R.;Heydarpour, Pouria;Higashi, Hideki;Hijar, Martha;Hoek, Hans W.;Hoffman, Howard J.;Hornberger, John C.;Hosgood, H. Dean;Hossain, Mazeda;Hotez, Peter J.;Hoy, Damian G.;Hsairi, Mohamed;Hu, Guoqing;Huang, John J.;Huffman, Mark D.;Hughes, Andrew J.;Husseini, Abdullatif;Huynh, Chantal;Iannarone, Marissa;Iburg, Kim M.;Idrisov, Bulat T.;Ikeda, Nayu;Innos, Kaire;Inoue, Manami;Islami, Farhad;Ismayilova, Samaya;Jacobsen, Kathryn H.;Jassal, Simerjot;Jayaraman, Sudha P.;Jensen, Paul N.;Jha, Vivekanand;Jiang, Guohong;Jiang, Ying;Jonas, Jost B.;Joseph, Jonathan;Juel, Knud;Kabagambe, Edmond Kato;Kan, Haidong;Karch, Andre;Karimkhani, Chante;Karthikeyan, Ganesan;Kassebaum, Nicholas;Kaul, Anil;Kawakami, Norito;Kazanjan, Konstantin;Kazi, Dhruv S.;Kemp, Andrew H.;Kengne, Andre Pascal;Keren, Andre;Kereselidze, Maia;Khader, Yousef Saleh;Khalifa, Shams Eldin Ali Hassan;Khan, Ejaz Ahmed;Khan, Gulfaraz;Khang, Young-Ho;Kieling, Christian;Kinfu, Yohannes;Kinge, Jonas M.;Kim, Daniel;Kim, Sungroul;Kivipelto, Miia;Knibbs, Luke;Knudsen, Ann Kristin;Kokubo, Yoshihiro;Kosen, Sowarta;Kotagal, Meera;Kravchenko, Michael A.;Krishnaswami, Sanjay;Krueger, Hans;Defo, Barthelemy Kuate;Kuipers, Ernst J.;Bicer, Burcu Kucuk;Kulkarni, Chanda;Kulkarni, Veena S.;Kumar, Kaushalendra;Kumar, Ravi B.;Kwan, Gene F.;Kyu, Hmwe;Lai, Taavi;Balaji, Arjun Lakshmana;Lalloo, Ratilal;Lallukka, Tea;Lam, Hilton;Lan, Qing;Lansingh, Van C.;Larson, Heidi J.;Larsson, Anders;Lavados, Pablo M.;Lawrynowicz, Alicia E. B.;Leasher, Janet L.;Lee, Jong-Tae;Leigh, James;Leinsalu, Mall;Leung, Ricky;Levitz, Carly;Li, Bin;Li, Yichong;Li, Yongmei;Liddell, Chelsea;Lim, Stephen S.;de Lima, Graca Maria Ferreira;Lind, Maggie L.;Lipshultz, Steven E.;Liu, Shiwei;Liu, Yang;Lloyd, Belinda K.;Lofgren, Katherine T.;Logroscino, Giancarlo;London, Stephanie J.;Lortet-Tieulent, Joannie;Lotufo, Paulo A.;Lucas, Robyn M.;Lunevicius, Raimundas;Lyons, Ronan Anthony;Ma, Stefan;Machado, Vasco Manuel Pedro;MacIntyre, Michael F.;Mackay, Mark T.;MacLachlan, Jennifer H.;Magis-Rodriguez, Carlos;Mahdi, Abbas A.;Majdan, Marek;Malekzadeh, Reza;Mangalam, Srikanth;Mapoma, Christopher Chabila;Marape, Marape;Marcenes, Wagner;Margono, Christopher;Marks, Guy B.;Marzan, Melvin Barrientos;Masci, Joseph R.;Mashal, Mohammad Taufi Q.;Masiye, Felix;Mason-Jones, Amanda J.;Matzopolous, Richard;Mayosi, Bongani M.;Mazorodze, Tasara T.;McGrath, John J.;Mckay, Abigail C.;Mckee, Martin;McLain, Abigail;Meaney, Peter A.;Mehndiratta, Man Mohan;Mejia-Rodriguez, Fabiola;Melaku, Yohannes Adama;Meltzer, Michele;Memish, Ziad A.;Mendoza, Walter;Mensah, George A.;Meretoja, Atte;Mhimbira, Francis A.;Miller, Ted R.;Mills, Edward J.;Misganaw, Awoke;Mishra, Santosh K.;Mock, Charles N.;Moffitt, Terrie E.;Ibrahim, Norlinah Mohamed;Mohammad, Karzan Abdulmuhsin;Mokdad, Ali H.;Mola, Glen Liddell;Monasta, Lorenzo;Monis, Jonathan de la Cruz;Hernandez, Julio C. Montaez;Montico, Marcella;Montine, Thomas J.;Mooney, Meghan D.;Moore, Ami R.;Moradi-Lakeh, Maziar;Moran, Andrew E.;Mori, Rintaro;Moschandreas, Joanna;Moturi, Wilkister Nyaora;Moyer, Madeline L.;Mozaffarian, Dariush;Mueller, Ulrich O.;Mukaigawara, Mitsuru;Mullany, Erin C.;Murray, Joseph;Mustapha, Adetoun;Naghavi, Paria;Naheed, Aliya;Naidoo, Kovin S.;Naldi, Luigi;Nand, Devina;Nangia, Vinay;Narayan, K. M. Venkat;Nash, Denis;Nasher, Jamal;Nejjari, Chakib;Nelson, Robert G.;Neuhouser, Marian;Neupane, Sudan Prasad;Newcomb, Polly A.;Newman, Lori;Newton, Charles R.;Ng, Marie;Ngalesoni, Frida Namnyak;Nguyen, Grant;Nhung Thi Trang Nguyen;Nisar, Muhammad Imran;Nolte, Sandra;Norheim, Ole F.;Norman, Rosana E.;Norrving, Bo;Nyakarahuka, Luke;Odell, Shaun;O'Donnell, Martin;Ohkubo, Takayoshi;Ohno, Summer Lockett;Olusanya, Bolajoko O.;Omer, Saad B.;Opio, John Nelson;Orisakwe, Orish Ebere;Ortblad, Katrina F.;Ortiz, Alberto;Otayza, Maria Lourdes K.;Pain, Amanda W.;Pandian, Jeyaraj D.;Panelo, Carlo Irwin;Panniyammakal, Jeemon;Papachristou, Christina;Paternina Caicedo, Angel J.;Patten, Scott B.;Patton, George C.;Paul, Vinod K.;Pavlin, Boris;Pearce, Neil;Pellegrini, Carlos A.;Pereira, David M.;Peresson, Sophie C.;Perez-Padilla, Rogelio;Perez-Ruiz, Fernando P.;Perico, Norberto;Pervaiz, Aslam;Pesudovs, Konrad;Peterson, Carrie B.;Petzold, Max;Phillips, Bryan K.;Phillips, David E.;Phillips, Michael R.;Plass, Dietrich;Piel, Frederic Bernard;Poenaru, Dan;Polinder, Suzanne;Popova, Svetlana;Poulton, Richie G.;Pourmalek, Farshad;Prabhakaran, Dorairaj;Qato, Dima;Quezada, Amado D.;Quistberg, D. Alex;Rabito, Felicia;Rafay, Anwar;Rahimi, Kazem;Rahimi-Movaghar, Vafa;Rahman, Sajjad U. R.;Raju, Murugesan;Rakovac, Ivo;Rana, Saleem M.;Refaat, Amany;Remuzzi, Giuseppe;Ribeiro, Antonio L.;Ricci, Stefano;Riccio, Patricia M.;Richardson, Lee;Richardus, Jan Hendrik;Roberts, Bayard;Roberts, D. Allen;Robinson, Margaret;Roca, Anna;Rodriguez, Alina;Rojas-Rueda, David;Ronfani, Luca;Room, Robin;Roth, Gregory A.;Rothenbacher, Dietrich;Rothstein, David H.;Rowley, Jane Tf;Roy, Nobhojit;Ruhago, George M.;Rushton, Lesley;Sambandam, Sankar;Soreide, Kjetil;Saeedi, Mohammad Yahya;Saha, Sukanta;Sahathevan, Ramesh;Sahraian, Mohammad Ali;Sahle, Berhe Weldearegawi;Salomon, Joshua A.;Salvo, Deborah;Samonte, Genesis May J.;Sampson, Uchechukwu;Sanabria, Juan Ramon;Sandar, Logan;Santos, Itamar S.;Satpathy, Maheswar;Sawhney, Monika;Saylan, Mete;Scarborough, Peter;Schoettker, Ben;Schmidt, Juergen C.;Schneider, Ione J. C.;Schumacher, Austin E.;Schwebel, David C.;Scott, James G.;Sepanlou, Sadaf G.;Servan-Mori, Edson E.;Shackelford, Katya;Shaheen, Amira;Shahraz, Saeid;Shakh-Nazarova, Marina;Shangguan, Siyi;She, Jun;Sheikhbahaei, Sara;Shepard, Donald S.;Shibuya, Kenji;Shinohara, Yukito;Shishani, Kawkab;Shiue, Ivy;Shivakoti, Rupak;Shrime, Mark G.;Sigfusdottir, Inga Dora;Silberberg, Donald H.;Silva, Andrea P.;Simard, Edgar P.;Sindi, Shireen;Singh, Jasvinder A.;Singh, Lavanya;Sioson, Edgar;Skirbekk, Vegard;Sliwa, Karen;So, Samuel;Soljak, Michael;Soneji, Samir;Soshnikov, Sergey S.;Sposato, Luciano A.;Sreeramareddy, Chandrashekhar T.;Stanaway, Jeff Rey D.;Stathopoulou, Vasiliki Kalliopi;Steenland, Kyle;Stein, Claudia;Steiner, Caitlyn;Stevens, Antony;Stoeckl, Heidi;Straif, Kurt;Stroumpoulis, Konstantinos;Sturua, Lela;Sunguya, Bruno F.;Swaminathan, Soumya;Swaroop, Mamta;Sykes, Bryan L.;Tabb, Karen M.;Takahashi, Ken;Talongwa, Roberto Tchio;Tan, Feng;Tanne, David;Tanner, Marcel;Tavakkoli, Mohammad;Ao, Braden Te;Teixeira, Carolina Maria;Templin, Tara;Tenkorang, Eric Yeboah;Terkawi, Abdullah Sulieman;Thomas, Bernadette A.;Thorne-Lyman, Andrew L.;Thrift, Amanda G.;Thurston, George D.;Tillmann, Taavi;Tirschwell, David L.;Tleyjeh, Imad M.;Tonelli, Marcello;Topouzis, Fotis;Towbin, Jeffrey A.;Toyoshima, Hideaki;Traebert, Jefferson;Tran, Bach X.;Truelsen, Thomas;Trujillo, Ulises;Trillini, Matias;Dimbuene, Zacharie Tsala;Tsilimbaris, Miltiadis;Tuzcu, E. Murat;Ubeda, Clotilde;Uchendu, Uche S.;Ukwaja, Kingsley N.;Undurraga, Eduardo A.;Vallely, Andrew J.;van de Vijver, Steven;van Gool, Coen H.;Varakin, Yuri Y.;Vasankari, Tommi J.;Vasconcelos, Ana Maria Nogales;Vavilala, Monica S.;Venketasubramanian, N.;Vijayakumar, Lakshmi;Villalpando, Salvador;Violante, Francesco S.;Vlassov, Vasiliy Victorovich;Wagner, Gregory R.;Waller, Stephen G.;Wang, JianLi;Wang, Linhong;Wang, XiaoRong;Wang, Yanping;Warouw, Tati Suryati;Weichenthal, Scott;Weiderpass, Elisabete;Weintraub, Robert G.;Wenzhi, Wang;Werdecker, Andrea;Wessells, K. Ryan R.;Westerman, Ronny;Whiteford, Harvey A.;Wilkinson, James D.;Williams, Thomas Neil;Woldeyohannes, Solomon Meseret;Wolfe, Charles D. A.;Wolock, Timothy M.;Woolf, Anthony D.;Wong, John Q.;Wright, Jonathan L.;Wulf, Sarah;Wurtz, Brittany;Xu, Gelin;Yang, Yang C.;Yano, Yuichiro;Yatsuya, Hiroshi;Yip, Paul;Yonemoto, Naohiro;Yoon, Seok-Jun;Younis, Mustafa;Yu, Chuanhua;Jin, Kim Yun;Zaki, Maysaa El Sayed;Zamakhshary, Mohammed Fouad;Zeeb, Hajo;Zhang, Yong;Zhao, Yong;Zheng, Yingfeng;Zhu, Jun;Zhu, Shankuan;Zonies, David;Zou, Xiao Nong;Zunt, Joseph R.;Vos, Theo;Lopez, Alan D.;Murray, Christopher J. L.
关于按年龄-性别分列的全因和因别死亡率的水平和趋势的最新证据对于制定全球、区域和国家卫生政策至关重要。在2013年全球疾病负担研究（GBD 2013）中，我们估计了1990年至2013年期间188个国家的年死亡人数。我们使用这些结果来评估各国之间是否存在流行病学趋同。我们使用GBD 2010方法估算了年龄-性别-特异性全因死亡率，并进行了一些改进，以提高应用于更新的生命登记、调查和人口普查数据数据库的准确性。我们通常按照2010年GBD估计死因。主要改进包括增加了72个国家的最新生命登记数据，更新了死因推断文献综述，中国的两个新的详细数据系统，以及墨西哥，英国，土耳其和俄罗斯的更多细节。我们改进了垃圾代码再分发的统计模型。我们在240个原因中使用了六种不同的建模策略;死亡原因集成建模（CODEm）是具有足够信息的原因的主要策略。阿尔茨海默病和其他痴呆症的趋势是通过流行率研究的元回归得出的。对于腹泻和下呼吸道感染的病原体特异性原因，我们使用了反事实方法。我们计算了国家间收敛（不平等）的两个指标：所有国家对之间的平均相对差异（基尼系数）和国家间的平均绝对差异。为了总结广泛的研究结果，我们使用多重递减寿命表来分解从出生到确切年龄15岁，从确切年龄15岁到确切年龄50岁，从确切年龄50岁到确切年龄75岁的死亡概率，以及出生时的预期寿命。对于报告的所有数量，我们计算了95%的不确定性区间（UI）。我们限制了每个年龄性别国家年组中的特定原因分数，以根据不确定性分布得出全因死亡率。全球男女预期寿命从1990年的65.3岁（UI 65.0 - 65.6）增加到2013年的71.5岁（UI 71.0 - 71.9），而同一时期的死亡人数从4750万（UI 46.8 - 48.2）增加到5490万（UI 53.6 - 56.3）。全球进展掩盖了年龄和性别的差异：就儿童而言，各国之间的平均绝对差异减少，但相对差异增加。对于25-39岁和75岁以上的妇女以及20-49岁和65岁及以上的男子，绝对和相对差异都有所增加。对全球和区域预期寿命的分解显示，高收入地区心血管疾病和癌症年龄标准化死亡率的降低，以及低收入地区腹泻、下呼吸道感染和新生儿原因造成的儿童死亡率的降低，发挥了突出作用。艾滋病毒/艾滋病降低了撒哈拉以南非洲南部的预期寿命。对于大多数传染性死因，死亡人数和年龄标准化死亡率都有所下降，而对于大多数非传染性死因，人口结构的变化增加了死亡人数，但降低了年龄标准化死亡率。全球伤害死亡人数增加了10.7%，从1990年的430万人增加到2013年的480万人;但同期年龄标准化死亡率下降了21%。对于2013年每年超过10万人死亡的一些原因，年龄标准化死亡率在1990年至2013年期间有所增加，包括艾滋病毒/艾滋病，胰腺癌，心房颤动和扑动，药物使用障碍，糖尿病，慢性肾脏疾病和镰状细胞贫血。腹泻病、下呼吸道感染、新生儿疾病和疟疾仍然是5岁以下儿童死亡的五大原因。最重要的病原体是引起腹泻的轮状病毒和引起下呼吸道感染的肺炎球菌。各国在生命的三个阶段的死亡概率在区域之间和区域内有很大差异。对大多数国家而言，按年龄-性别分列的死亡率下降的一般模式与非传染性疾病和伤害造成的其余死亡所占比例逐渐增加有关。对各国流行病趋同的评估取决于是否使用了绝对或相对的不平等衡量标准。然而，七种主要原因的年龄标准化死亡率正在上升，这表明在一些国家有可能逆转。一些国家的死因估计经验数据存在重大差距;例如，印度没有过去十年的国家数据。
Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer’s disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.