2008—2019年无锡市跌倒死亡的疾病负担及对期望寿命的影响分析

目的 分析江苏省无锡市2008—2019年跌倒死亡导致的疾病负担及对期望寿命的影响，为制定干预措施提供依据。方法 利用2008—2019年无锡市全人群死因监测数据，计算跌倒死亡率和早死所致寿命损失年（years of life lost, YLL），以平均年度变化百分比（average annual percent change, AAPC）分析变化趋势及对期望寿命增量的贡献。结果 2008—2019年无锡市居民跌倒粗死亡率AAPC为7.0%（95%CI: 4.8～9.4）（P＜0.05）和标化死亡率AAPC为3.7%（95%CI: 1.4～6.0）均呈上升趋势（P＜0.05）。2008—2019年因跌倒死亡中，女性占比达到57.62%，略高于男性，且60岁及以上老年人占比达到89.98%。2008—2019年因跌倒死亡导致的期望寿命平均下降了0.11岁（6.43%），且对女性影响大于男性。2008—2019年全人群和60岁及以上老年人因跌倒死亡导致的YLL率均呈上升趋势，AAPC分别为3.3%（95%CI: 1.2～5.5）（P＜0.05）和4.5%（95%CI: 2.0～7.0）（P＜0.05），其中2019年的60岁及以上老年人的YLL率已达到13.10/千人年。结论 无锡市居民因跌倒导致的死亡和疾病负担呈上升趋势，对期望寿命增长呈负向效应，以60岁及以上老年人为主，应加强对老年人群预防跌倒的宣传和干预。

Analysis on disease burden due to death from falls and its impact on life expectancy in Wuxi from 2008 to 2019

Objective To analyze the burden of disease and impact on life expectancy due to fall deaths in Wuxi city, Jiangsu Province, from 2008 to 2019, and to provide a basis for developing interventions. Methods Using population-wide cause of death surveillance data in Wuxi from 2008 to 2019, we calculated the fall mortality rate and years of life lost (YLL) due to premature death and analyzed the trend of change and its contribution to the incremental life expectancy with average annual percent change (AAPC). The contribution of YLL to the increment of life expectancy was analyzed by AAPC. Results The crude mortality rate AAPC of 7.0% (95%CI: 4.8-9.4) (P<0.05) and the standardized mortality rate AAPC of 3.7% (95%CI: 1.4-6.0) of Wuxi residents from 2008 to 2019 showed an increasing trend (P<0.05). The proportion of deaths due to falls in 2019 reached 57.62% for females, slightly higher than for males, and 89.98% for those aged 60 years and older. Life expectancy due to deaths due to falls decreased on average by 0.11 years (6.43%) from 2008 to 2019 and affected females more than males. The YLL rates from 2008 to 2019 due to death from falls trended upward for both the population as a whole and for those aged 60 years and older, with AAPCs of 3.3% (95%CI: 1.2-5.5) (P<0.05) and 4.5% (95%CI: 2.0-7.0) (P<0.05), respectively, with the 2019 the YLL rate reaching 13.10/1000 person-years. Conclusion The burden of death and disease due to falls among Wuxi residents is on the rise, with a negative effect on the growth of life expectancy, predominantly among those aged 60 years and older, and the publicity and intervention for fall prevention among the elderly population should be strengthened.