2012—2018年重庆市伤害疾病负担变化趋势

目的分析重庆市伤害死亡及疾病负担变化趋势,为开展伤害防控工作提供建议。方法收集分析2012—2018年重庆市伤害死亡个案(ICD-10编码:V01-V99,W00-W99,X00-X99,Y0-Y98),采用SPSS 25.0统计分析伤害死亡率、标化死亡率、顺位、早死所致的寿命损失年(years of life lost with premature death, YLLs)、残疾所致寿命损失年(years lived with disability, YLDs)、伤残调整生命年(disability adjusted life years, DALYs)等指标,率的比较采用χ~2检验,趋势变化采用曲线估计计算年度变化百分比(annual percent change, APC),其统计学差异采用t检验。结果重庆市伤害死亡率与标化死亡率分别由2012年的55.73/10万、47.63/10万下降到2018年的45.09/10万、35.99/10万,APC为-3.92%与-5.26%,变化趋势差异有统计学意义(t=4.23、4.47,P<0.05)。历年伤害死亡率男性高于女性(均P<0.05),农村高于城市(均P<0.05)。历年死亡率居前六位伤害分别是跌倒、道路交通事故、自杀、溺水、中毒、意外窒息。伤害的每千人早死所致的YLLs、YLDs、DALYs分别由2012年22.64千人年、6.45千人年、29.09千人年下降到2018年的14.70千人年、4.19千人年、18.89千人年,APC分别为-7.60%、-7.78%、-7.60%,变化趋势差异有统计学意义(t=6.80、8.10、6.79,均P<0.05)。结论重庆市伤害死亡率与疾病负担呈下降的趋势,但仍处于较高的水平,应重点针对男性、农村地区、道路交通伤害、跌倒开展伤害的预防控制工作。

Changing trend of disease burden of injuries in Chongqing, 2012-2018

Objective To analyze the changing trend of mortality and disease burden of injuries in Chongqing from 2012 to 2018, and to provide suggestions for injury prevention and control. Methods Injury-induced death cases (ICD-10 code:V01-V99, W00-W99, X00-X99 and Y0-Y98) in Chongqing from 2012 to 2018 were collected. Indicators like the mortality rate of injury, age-standardized mortality rate by Chinese population (ASMRC), rank order, years of life lost with premature death (YLLs), years lived with disability (YLDs) and disability adjusted life years (DALYs) were analyzed by SPSS 25.0 software. The differences in the mortality rates were tested by Chi-square test. Curve-estimation logistic regression model was used to calculate annual percent change (APC) on the mortality rates. The statistical differences in APC were tested by t-test. Results The mortality rate and ASMRC of injuries in Chongqing deceased from 55.73/100,000 and 47.63/100,000 in 2012 to 45.09/100,000 and 35.99/100,000 in 2018, and the APC was -3.92% and -5.26%, respectively, showing a statistically significant difference in the changing trend(t=4.23, t=4.47%, P<0.05). The mortality rates of injuries in each year during the period 2012 through 2018 were all higher in males than in females (all P<0.05) as well as all higher in rural areas than in urban areas (all P<0.05). The injuries with mortality rates ranking top six positions in each year during the period 2012 through 2018 were fall, road traffic accident, suicide, drowning, poisoning and accidental suffocation.The YLLs, YLDs and DALYs of injuries decreased from 22.64 thousand person-years, 6.45 thousand person-years and 29.09 thousand person-years in 2012 to 14.70 thousand person-years,4.19 thousand person-years and 18.89 thousand person-years in 2018, and their APC was -7.60%, -7.78% and -7.60%,respectively, showing statistically significant differences in the changing trend(t=6.80, t=8.10, t=6.79, all P<0.05). Conclusions The mortality rate and disease burden of injuries in Chongqing during 2012-2018 showed downward trends, but still remained a high level. Injury prevention and control should focus on males, rural areas, road traffic accidents and fall.