1990至2019年中国居民机械伤发生及死亡趋势分析  

Tendency analysis of incidence and mortality of mechanical injuries among Chinese residents from 1990 to 2019

作　　者：刘涛[1] 杨召 李方国 李悦[1] 刘鑫[1] 武镇龙 曹春霞 Liu Tao;Yang Zhao;Li Fangguo;Li Yue;Liu Xin;Wu Zhenlong;Cao Chunxia(Institute of Disaster and Emergency Medicine,Tianjin University,Tianjin 300072,China;Department of Orthopaedics,Tianjin Hospital of Tianjin University,Tianjin 300211,China;Tianjin Trauma Emergency Center,Tianjin 300211,China)

机构地区：[1]天津大学应急医学研究院,天津300072 [2]天津大学天津医院骨科,天津300211 [3]天津市创伤急救中心,天津300211

出　　处：《中华危重病急救医学》2022年第10期1082-1087,共6页Chinese Critical Care Medicine

基　　金：国家重点研发计划重点专项(2019YFC1606304-01)。

摘　　要：目的分析1990至2019年中国居民机械伤发生及死亡趋势并估计其年龄-时期-队列效应。方法基于2019年全球疾病负担(GBD)数据库,提取1990至2019年中国居民机械伤发生率和致死率数据,采用联结点回归模型分析中国全人群不同性别间机械伤年龄标准化发生率(ASIR)和年龄标准化致死率(ASDR)的变化趋势,并计算年变化百分比(APC)和平均年度变化百分比(AAPC)。采用年龄-时期-队列模型拟合,定量评估年龄、时期和队列对机械伤ASIR和ASDR的效应。结果①总体趋势:1990至2019年,中国居民机械伤ASIR总体呈上升趋势(1990年540.95/10万,2019年815.34/10万),ASDR总体呈先轻微上升再下降趋势(1990年2.62/10万,2005年2.87/10万,2019年1.77/10万)。观察期内,男性机械伤的ASIR及ASDR均高于女性。②联结点回归模型分析:1990至2019年中国居民机械伤的ASIR呈先上升后下降再迅速上升的波动增长趋势(AAPC=1.42%,t=9.59,P<0.001);其中男性ASIR呈轻微下降后持续上升的增长趋势(AAPC=1.47%,t=8.72,P<0.001),女性ASIR呈先上升后迅速下降再迅速上升的波动增长趋势(AAPC=1.31%,t=12.11,P<0.001);1990至2019年中国居民机械伤的ASDR呈先下降后上升再迅速下降的波动下降趋势(AAPC=-1.39%,t=-6.72,P<0.001);其中男性ASDR下降速度与全国持平(AAPC=-1.44%,t=-7.29,P<0.001),但女性ASDR下降速度相对缓慢(AAPC=-1.08%,t=-4.54,P<0.001)。③年龄-时期-队列模型分析:年龄效应方面,随年龄增长,中国全人群、男性和女性机械伤的发生风险均呈上升后下降然后再迅速上升的趋势,达到第一个小高峰年龄在男性为45~49岁,女性则在65~69岁;死亡风险整体呈随年龄增长而增加的趋势,在75岁前呈缓慢上升趋势,75岁后各人群死亡风险骤然升高;发生风险和死亡风险最高峰年龄均在90~94岁。时期效应方面,随时间推移,中国全人群、男性和女性机械伤发生风险总体呈逐渐上升趋势,死亡风险总体呈�Objective To analyze the tendency of incidence and mortality of mechanical injuries among Chinese residents from 1990 through 2019 and to estimate the age-period-cohort effect.Methods Based on the Global Burden of Disease(GBD)2019 database,the incidence and mortality data of mechanical injuries among Chinese residents from 1990 to 2019 were extracted.The trends of age-standardized incidence rate(ASIR)and age-standardized death rate(ASDR)of mechanical injuries among Chinese residents by gender was analyzed using the joinpoint regression model,and the annual percent change(APC)and average annual percent change(AAPC)were calculated.The age-period-cohort model was used to quantitatively assess the effects of age,period,and cohort on ASIR and ASDR for mechanical injuries.Results①Overall tendency:from 1990 to 2019,the ASIR of mechanical injuries showed an increasing trend(540.95/100000 in 1990 vs.815.34/100000 in 2019),and the ASDR first increased slightly and then decreased(2.62/100000 in 1990 vs.2.87/100000 in 2005 vs.1.77/100000 in 2019)among Chinese residents.During the observation period,ASIR and ASDR for mechanical injuries of male were higher than female.②Joinpoint regression model analysis showed that the ASIR of mechanical injuries had a fluctuating trend of increasing first and then decreasing and then rising rapidly among Chinese residents from 1990 to 2019(AAPC=1.42%,t=9.59,P<0.001).The ASIR of the Chinese male showed a slight decrease and then continued to increase(AAPC=1.47%,t=8.72,P<0.001),while the ASIR of the Chinese female showed a rapid rising at first,then rapidly declining and then rising again(AAPC=1.31%,t=12.11,P<0.001).From 1990 to 2019,the ASDR of mechanical injuries showed a fluctuating downward trend of first decreasing,then increasing,and then rapidly decreasing among Chinese residents(AAPC=-1.39%,t=-6.72,P<0.001).The decrease rate of ASDR among male was as same as that among all population(AAPC=-1.44%,t=-7.29,P<0.001),but the decrease rate of ASDR in female was relatively slow(AAPC=-1.0

关 键 词：机械伤 趋势分析 联结点回归模型 年龄-时期-队列模型 中国居民 

分 类 号：R641[医药卫生—外科学]