77 research outputs found
Management of simultaneous bilateral femur fractures in a tertiary care hospital: a retrospective review
- Publication venue
- eCommons@AKU
- Publication date
- 01/01/2017
- Field of study
Abstract: Introduction: Bilateral long bone fractures are rare and usually are associated with increased risk of complications. These fractures are usually associated with poly traumatic injuries or high impact trauma resulting in shock. Commonest etiology is road traffic accident. Closed diaphyseal fractures are best managed by intramedullary nailing; management becomes difficult if there are open fractures and late arrival. In this study we intend to present our experience of managing these patients. Materials and Methods: Medical records of all adult patients (age more than 16 years of age) admitted at Aga Khan University and Hospital with bilateral femur fractures +/- other systemic injuries 2006-2014 were reviewed retrospectively. Adult patients with complete medical records were included and patients with missing data were excluded from the study. SPSS version 19 was used for data entering and Statistical analysis. Results: We retrieved 11 cases of bilateral femur fractures. Mean age of patients was 34.5 +/- 20.9, with male predominance constituting 72.7%. Common mode of injury was fall from height and road traffic accident (RTA) 45.5% each, with the exception of one gunshot. Mean Injury Severity Score was 26.9+/-7.79. Mean Revised Trauma Score was 7.39 +/-0.62; mean Trauma Injury and Severity Score was 92.4 +/- 6.6%. 2 patients had surgical site infections and 1 had non-union. We encountered no mortality. Increase ISS is associated with increased risk of morbidity and length of hospital stay (p= 0.02
In Silico Bioinformatics Followed by Molecular Validation Using Archival FFPE Tissue Biopsies Identifies a Panel of Transcripts Associated with Severe Asthma and Lung Cancer
- Author
- Publication venue
- 'MDPI AG'
- Publication date
- 01/04/2022
- Field of study
Severe asthma and lung cancer are both heterogeneous pathological diseases affecting the lung tissue. Whilst there are a few studies that suggest an association between asthma and lung cancer, to the best of our knowledge, this is the first study to identify common genes involved in both severe asthma and lung cancer. Publicly available transcriptomic data for 23 epithelial brushings from severe asthmatics and 55 samples of formalin-fixed paraffin-embedded (FFPE) lung cancer tissue at relatively early stages were analyzed by absolute gene set enrichment analysis (GSEA) in comparison to 37 healthy bronchial tissue samples. The key pathways enriched in asthmatic patients included adhesion, extracellular matrix, and epithelial cell proliferation, which contribute to tissue remodeling. In the lung cancer dataset, the main pathways identified were receptor tyrosine kinase signaling, wound healing, and growth factor response, representing the early cancer pathways. Analysis of the enriched genes derived from the pathway analysis identified seven genes expressed in both the asthma and lung cancer sets: BCL3, POSTN, PPARD, STAT1, MYC, CD44, and FOSB. The differential expression of these genes was validated in vitro in the cell lines retrieved from different lung cancer and severe asthma patients using real-time PCR. The effect of the expression of the seven genes identified in the study on the overall survival of lung cancer patients (n = 1925) was assessed using a Kaplan–Meier plot. In vivo validation performed in the archival biopsies obtained from patients diagnosed with both the disease conditions provided interesting insights into the pathogenesis of severe asthma and lung cancer, as indicated by the differential expression pattern of the seven transcripts in the mixed group as compared to the asthmatics and lung cancer samples alone
Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Abate Kalkidan Hassen
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi Madineh Akram
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbasifard Mitra
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdi Parsa
- Abdollahi Mohammad
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abedi Aidin
- Abedi Armita
- Abegaz Tadesse M
- Abeldaño Zuñiga Roberto Ariel
- Abiodun Olumide
- Abiso Temesgen Lera
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abu-Gharbieh Eman
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Abukhadijah Hana Jihad Jihad
- Aburuz Salahdein
- Adane Mesafint Molla
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adedoyin Rufus Adesoji
- Adekanmbi Victor
- Aden Bashir
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adha Rishan
- Adibi Amin
- Adnani Qorinah Estiningtyas Sakilah
- Adzigbli Leticia Akua
- Afolabi Aanuoluwapo Adeyimika
- Afolabi Rotimi Felix
- Afshin Ashkan
- Afyouni Shadi
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agbozo Faith
- Aghamiri Shahin
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Noah
- Ahmad Shahzaib
- Ahmad Tauseef
- Ahmed Ali
- Ahmed Anisuddin
- Ahmed Ayman
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ahmed Safoora
- Ahmed Syed Anees
- Ajami Marjan
- Akalu Gizachew Taddesse
- Akara Essona Matatom
- Akbarialiabad Hossein
- Akhlaghi Shiva
- Akinosoglou Karolina
- Akinyemiju Tomi
- Akkaif Mohammed Ahmed
- Akkala Sreelatha
- Akombi-Inyang Blessing
- Al Awaidy Salah
- Al Hasan Syed Mahfuz
- AL-Ahdal Tareq Mohammed Ali
- Al-Aly Ziyad
- Al-Fatly Bassam
- Al-Gheethi Adel Ali Saeed
- Al-Habbal Khairat
- Al-Marwani Sabah
- Al-Mekhlafi Hesham M
- Al-Raddadi Rajaa M
- Al-Rifai Rami Hani
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Wardat Mohammad Sami
- Al-Worafi Yaser Mohammed
- Al-Zyoud Walid
- Alahdab Fares
- Alalalmeh Samer O
- Alalwan Tariq A
- Alam Khurshid
- Alam Nazmul
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albakri Almaza
- AlBataineh Mohammad T
- Aldhaleei Wafa A
- Aldridge Robert W
- Alemayohu Mulubirhan Assefa
- Alemu Yihun Mulugeta
- Alhabib Khalid F
- Alhassan Robert Kaba
- Ali Abid
- Ali Amjad
- Ali Beriwan Abdulqadir
- Ali Iman
- Ali Liaqat
- Ali Mohammed Usman
- Ali Rafat
- Ali Syed Shujait Shujait
- Ali Waad
- Alicandro Gianfranco
- Alif Sheikh Mohammad
- Aljunid Syed Mohamed
- Alla François
- Almustanyir Sami
- Alomari Mahmoud A
- Alonso Jordi
- Alqahtani Jaber S
- Alqutaibi Ahmed Yaseen
- Alrawashdeh Ahmad
- Alrousan Sahel Majed
- Alshahrani Najim Z
- Altaany Zaid
- Altaf Awais
- Altirkawi Khalid A
- Aluh Deborah Oyine
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J
- Alwafi Hassan
- Aly Hany
- Aly Safwat
- Alzoubi Karem H
- Amaechi Uchenna Anderson
- Aman Mohammadi Masous
- Amani Reza
- Amiri Sohrab
- Amirzade-Iranaq Mohammad Hosein
- Ammirati Enrico
- Amu Hubert
- Amugsi Dickson A
- Amusa Ganiyu Adeniyi
- Ancuceanu Robert
- Anderlini Deanna
- Anderson Jason A
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Andrei Tudorel
- Anenberg Susan C
- Angappan Dhanalakshmi
- Angus Colin
- Anil Abhishek
- Anil Sneha
- Anjum Afifa
- Anoushiravani Amir
- Antonazzo Ippazio Cosimo
- Antony Catherine M
- Antriyandarti Ernoiz
- Anuoluwa Boluwatife Stephen
- Anvari Davood
- Anvari Saeid
- Anwar Saleha
- Anwar Sumadi Lukman
- Anwer Razique
- Anyabolo Ekenedilichukwu Emmanuel
- Anyasodor Anayochukwu Edward
- Apostol Geminn Louis Carace
- Arabloo Jalal
- Arabzadeh Bahri Razman
- Arafat Mosab
- Aravkin Aleksandr Y
- Areda Demelash
- Aregawi Brhane Berhe
- Aremu Abdulfatai
- Armocida Benedetta
- Arndt Michael Benjamin
- Arooj Mahwish
- Artamonov Anton A
- Artanti Kurnia Dwi
- Aruleba Idowu Thomas
- Arumugam Ashokan
- Asbeutah Akram M
- Asgary Saeed
- Asgedom Akeza Awealom
- Ashbaugh Charlie
- Ashemo Mubarek Yesse
- Ashraf Tahira
- Askarinejad Amir
- Assmus Michael
- Astell-Burt Thomas
- Athar Mohammad
- Athari Seyyed Shamsadin
- Atorkey Prince
- Atreya Alok
- Aujayeb Avinash
- Ausloos Marcel
- Avila-Burgos Leticia
- Awoke Andargie Abate
- Ayala Quintanilla Beatriz Paulina
- Ayatollahi Haleh
- Ayestas Portugal Carlos
- Ayuso-Mateos Jose L
- Azadnajafabad Sina
- Azevedo Rui M S
- Azhar Gulrez Shah
- Azizi Hosein
- Azzam Ahmed Y
- Ärnlöv Johan
- Backhaus Insa Linnea
- Badar Muhammad
- Badiye Ashish D
- Bagga Arvind
- Baghdadi Soroush
- Bagheri Nasser
- Bagherieh Sara
- Bahrami Taghanaki Pegah
- Bai Ruhai
- Baig Atif Amin
- Baker Jennifer L
- Bakkannavar Shankar M
- Balasubramanian Madhan
- Baltatu Ovidiu Constantin
- Bam Kiran
- Bandyopadhyay Soham
- Banik Biswajit
- Banik Palash Chandra
- Banke-Thomas Aduragbemi
- Bansal Hansi
- Barchitta Martina
- Bardhan Mainak
- Bardideh Erfan
- Barker-Collo Suzanne Lyn
- Barone-Adesi Francesco
- Barqawi Hiba Jawdat
- Barrero Lope H
- Barrow Amadou
- Barteit Sandra
- Basharat Zarrin
- Basiru Afisu
- Basso João Diogo
- Bastan Mohammad-Mahdi
- Basu Sanjay
- Batchu Sai
- Batra Kavita
- Batra Ravi
- Baune Bernhard T
- Bayati Mohsen
- Bayileyegn Nebiyou Simegnew
- Bärnighausen Till Winfried
- Beaney Thomas
- Behnoush Amir Hossein
- Beiranvand Maryam
- Bekele Alehegn
- Belgaumi Uzma Iqbal
- Bell Arielle Wilder
- Bell Michelle L
- Bello Muhammad Bashir
- Bello Olorunjuwon Omolaja
- Belo Luis
- Beloukas Apostolos
- Bendak Salaheddine
- Bennett Derrick A
- Bennitt Fiona B
- Bensenor Isabela M
- Benzian Habib
- Beran Azizullah
- Berezvai Zombor
- Bernabe Eduardo
- Bernstein Robert S
- Bettencourt Paulo J G
- Béjot Yannick
- Bhagavathula Akshaya Srikanth
- Bhala Neeraj
- Bhandari Dinesh
- Bhardwaj Nikha
- Bhardwaj Pankaj
- Bhaskar Sonu
- Bhat Ajay Nagesh
- Bhat Vivek
- Bhatti Gurjit Kaur
- Bhatti Jasvinder Singh
- Bhatti Manpreet S
- Bhatti Rajbir
- Bhuiyan Mohiuddin Ahmed
- Bhutta Zulfiqar A
- Bikbov Boris
- Bishai Jessica Devin
- Bisignano Catherine
- Biswas Atanu
- Biswas Bijit
- Biswas Raaj Kishore
- Bjørge Tone
- Boachie Micheal Kofi
- Boakye Hosea
- Bockarie Moses John
- Bodolica Virginia
- Bodunrin Aadam Olalekan
- Bogale Eyob Ketema
- Bolla Srinivasa Rao
- Boloor Archith
- Bonakdar Hashemi Milad
- Boppana Sri Harsha
- Bora Basara Berrak
- Borhany Hamed
- Botero Carvajal Alejandro
- Bouaoud Souad
- Boufous Soufiane
- Bourne Rupert
- Boxe Christopher
- Braithwaite Dejana
- Brant Luisa C
- Brar Amanpreet
- Brauer Michael
- Breitborde Nicholas J K
- Breitner Susanne
- Brenner Hermann
- Briko Andrey Nikolaevich
- Britton Gabrielle
- Brown Colin Stewart
- Browne Annie J
- Brunoni Andre R
- Bryazka Dana
- Bulamu Norma B
- Bulto Lemma N
- Buonsenso Danilo
- Burkart Katrin
- Burns Richard A
- Busse Reinhard
- Bustanji Yasser
- Butt Nadeem Shafique
- Butt Zahid A
- Caetano dos Santos Florentino Luciano
- Cagney Jack
- Cahuana-Hurtado Lucero
- Calina Daniela
- Campos Luciana Aparecida
- Campos-Nonato Ismael R
- Cao Chao
- Cao Fan
- Cao Yubin
- Capodici Angelo
- Carr Sinclair
- Carreras Giulia
- Carrero Juan J
- Carugno Andrea
- Carvalho Felix
- Carvalho Márcia
- Castaldelli-Maia Joao Mauricio
- Castañeda-Orjuela Carlos A
- Castelpietra Giulio
- Catalá-López Ferrán
- Catapano Alberico L
- Cattaruzza Maria Sofia
- Caye Arthur
- Cámera Luis Alberto
- Cárdenas Rosario
- Cederroth Christopher R
- Cegolon Luca
- Cenderadewi Muthia
- Cercy Kelly M
- Cerin Ester
- Chadwick Joshua
- Chakraborty Chiranjib
- Chakraborty Promit Ananyo
- Chakraborty Sandip
- Chan Jeffrey Shi Kai
- Chan Raymond N C
- Chandan Joht Singh
- Chandika Rama Mohan
- Chaturvedi Pankaj
- Chen An-Tian
- Chen Catherine S
- Chen Haowei
- Chen Meng Xuan
- Chen Mingling
- Chen Simiao
- Cheng Ching-Yu
- Cheng Esther T W
- Cherbuin Nicolas
- Chi Gerald
- Chichagi Fatemeh
- Chimed-Ochir Odgerel
- Chimoriya Ritesh
- Ching Patrick R
- Chirinos-Caceres Jesus Lorenzo
- Chitheer Abdulaal
- Cho William C S
- Chong Bryan
- Chopra Hitesh
- Chowdhury Rajiv
- Christopher Devasahayam J
- Chu Dinh-Toi
- Chukwu Isaac Sunday
- Chung Eric
- Chung Sheng-Chia
- Chutiyami Muhammad
- Cioffi Iolanda
- Cogen Rebecca M
- Cohen Aaron J
- Columbus Alyssa
- Conde Joao
- Corlateanu Alexandru
- Cortese Samuele
- Cortesi Paolo Angelo
- Costa Vera Marisa
- Costanzo Simona
- Criqui Michael H
- Cruz Jessica A
- Cruz-Martins Natália
- Culbreth Garland T
- D'Amico Emanuele
- D'Anna Lucio
- D'Oria Mario
- da Silva Alanna Gomes
- Dadras Omid
- Dai Xiaochen
- Dai Zhaoli
- Daikwo Patience Unekwuojo
- Dalli Lachlan L
- Damiani Giovanni
- Darwesh Aso Mohammad
- Das Jai K
- Das Subasish
- Dash Nihar Ranjan
- Dashti Mohsen
- Davis Weaver Nicole
- Davitoiu Dragos Virgil
- Dávila-Cervantes Claudio Alberto
- De la Hoz Fernando Pio
- de la Torre-Luque Alejandro
- De Leo Diego
- Debopadhaya Shayom
- Degenhardt Louisa
- Del Bo' Cristian
- Delgado-Enciso Ivan
- Delgado-Saborit Juana Maria
- Demoze Chalachew Kassaw
- Denova-Gutiérrez Edgar
- Dervenis Nikolaos
- Dervišević Emina
- Desai Hardik Dineshbhai
- Desai Rupak
- Devanbu Vinoth Gnana Chellaiyan
- Dewan Syed Masudur Rahman
- Dhali Arkadeep
- Dhama Kuldeep
- Dhane Amol S
- Dhimal Mandira Lamichhane
- Dhimal Meghnath
- Dhingra Sameer
- Dhulipala Vishal R
- Dhungana Raja Ram
- Dias da Silva Diana
- Diaz Daniel
- Diaz Luis Antonio
- Diaz Michael J
- Dima Adriana
- Ding Delaney D
- Dinu Monica
- Djalalinia Shirin
- do Prado Camila Bruneli
- Do Thanh Chi
- Do Thao Huynh Phuong
- Dodangeh Masoud
- Dohare Sushil
- Dokova Klara Georgieva
- Dong Wanyue
- Dongarwar Deepa
- Dorostkar Fariba
- Dorsey E Ray
- Doshi Rajkumar
- Doshmangir Leila
- Dowou Robert Kokou
- Driscoll Tim Robert
- Dsouza Ashel Chelsea
- Dsouza Haneil Larson
- Dumith Samuel C
- Duncan Bruce B
- Duraes Andre Rodrigues
- Duraisamy Senbagam
- Dushpanova Anar
- Dzianach Paulina Agnieszka
- Dziedzic Arkadiusz Marian
- Ebrahimi Alireza
- Echieh Chidiebere Peter
- Ed-Dra Abdelaziz
- Edinur Hisham Atan
- Edvardsson David
- Edvardsson Kristina
- Efendi Ferry
- Eftekharimehrabad Aziz
- Eini Ebrahim
- Ekholuenetale Michael
- Ekundayo Temitope Cyrus
- El Arab Rabie Adel
- El Sayed Zaki Maysaa
- El-Dahiyat Faris
- Elemam Noha Mousaad
- Elgar Frank J
- ElGohary Ghada Metwally Tawfik
- Elhabashy Hala Rashad
- Elhadi Muhammed
- Elmehrath Ahmed O
- Elmeligy Omar Abdelsadek Abdou
- Elshaer Mohammed
- Elsohaby Ibrahim
- Emeto Theophilus I
- Esfandiari Negin
- Eshrati Babak
- Eslami Majid
- Esmaeili Sayed Vahid
- Estep Kara
- Etaee Farshid
- Fabin Natalia
- Fagbamigbe Adeniyi Francis
- Fagbule Omotayo Francis
- Fahimi Saman
- Falzone Luca
- Fareed Mohammad
- Farinha Carla Sofia e Sá
- Faris MoezAlIslam Ezzat Mahmoud
- Faris Pawan Sirwan
- Faro Andre
- Fasina Folorunso Oludayo
- Fatehizadeh Ali
- Fauk Nelsensius Klau
- Fazylov Timur
- Feigin Valery L
- Feng Xiaoqi
- Fereshtehnejad Seyed-Mohammad
- Feroze Abdullah Hamid
- Ferrara Pietro
- Ferrari Alize J
- Ferreira Nuno
- Fetensa Getahun
- Feyisa Bikila Regassa
- Filip Irina
- Fischer Florian
- Fitriana Ida
- Flavel Joanne
- Flohr Carsten
- Flood David
- Flor Luisa S
- Foigt Nataliya A
- Folayan Morenike Oluwatoyin
- Force Lisa M
- Fortuna Daniela
- Foschi Matteo
- Franklin Richard Charles
- Freitas Alberto
- Friedman Sara D
- Fux Blima
- G Sridevi
- Gaal Peter Andras
- Gaihre Santosh
- Gajdács Márió
- Gakidou Emmanuela
- Galali Yaseen
- Gallus Silvano
- Gandhi Aravind P
- Ganesan Balasankar
- Ganiyani Mohammad Arfat
- Garcia Vanessa
- Gardner William M
- Garg Ravindra K
- Gautam Rupesh K
- Gebi Tilaye Gebru
- Gebregergis Miglas W
- Gebrehiwot Mesfin
- Gebremariam Tesfay B B
- Gebremeskel Teferi Gebru
- Gerema Urge
- Getacher Lemma
- Getahun Genanew K a
- Getie Molla
- Ghadirian Fataneh
- Ghafarian Sadegh
- Ghaffari Jolfayi Amir
- Ghailan Khalid Yaser
- Ghajar Alireza
- Ghasemi MohammadReza
- Ghasempour Dabaghi Ghazal
- Ghasemzadeh Afsaneh
- Ghassemi Fariba
- Ghazy Ramy Mohamed
- Gholami Ali
- Gholamrezanezhad Ali
- Gholizadeh Nasim
- Ghorbani Mahsa
- Gil Artyom Urievich
- Gil Gabriela Fernanda
- Gilbertson Nora M
- Gill Paramjit Singh
- Gill Tiffany K
- Gindaba Ebisa Zerihun
- Girmay Alem
- Glasbey James C
- Gnedovskaya Elena V
- Godinho Myron Anthony
- Goel Amit
- Golechha Mahaveer
- Goleij Pouya
- Golinelli Davide
- Gomes Nelson G M
- Gopalani Sameer Vali
- Gorini Giuseppe
- Goudarzi Houman
- Goulart Alessandra C
- Gouravani Mahdi
- Goyal Anmol
- Göbölös Laszlo
- Graham Simon Matthew
- Grivna Michal
- Grosso Giuseppe
- Guan Shi-Yang
- Guarducci Giovanni
- Gubari Mohammed Ibrahim Mohialdeen
- Guha Avirup
- Guicciardi Stefano
- Gulati Snigdha
- Gulisashvili David
- Gunawardane Damitha Asanga
- Guo Cui
- Gupta Anish Kumar
- Gupta Bhawna
- Gupta Mohak
- Gupta Rahul
- Gupta Rajat Das
- Gupta Rajeev
- Gupta Sapna
- Gupta Veer Bala
- Gupta Vijai Kumar
- Gupta Vivek Kumar
- Habibzadeh Farrokh
- Habibzadeh Parham
- Hadaro Tesfahun Simon
- Hadian Zahra
- Haep Nils
- Haghi-Aminjan Hamed
- Haghmorad Dariush
- Hagins Hailey
- Haile Demewoz
- Hailu Alemayehu
- Hajj Ali Adel
- Halboub Esam S
- Halimi Aram
- Hall Brian J
- Haller Sebastian
- Halwani Rabih
- Hamadeh Randah R
- Hamdy Nadia M
- Hameed Sajid
- Hamidi Samer
- Hammoud Ahmad
- Hanif Asif
- Hanifi Nasrin
- Haq Zaim Anan
- Haque Md Rabiul
- Harapan Harapan
- Hargono Arief
- Haro Josep Maria
- Hasaballah Ahmed I
- Hasan Ikramul
- Hasan Mohammad Jahid
- Hasan S M Mahmudul
- Hasani Hamidreza
- Hasanian Mohammad
- Hashmeh Nadim
- Hasnain Md Saquib
- Hassan Zadeh Tabatabaei Mahgol Sadat
- Hassan Amr
- Hassan Ikrama
- Hassani Shokoufeh
- Hassanipour Soheil
- Hassankhani Hadi
- Haubold Johannes
- Havmoeller Rasmus J
- Hay Simon I
- Hebert Jeffrey J
- Hegazi Omar E
- Hegena Tadele Yohannes
- Heidari Golnaz
- Heidari Mohammad
- Helfer Bartosz
- Hemmati Mehdi
- Henson Claire A
- Herbert Molly E
- Herteliu Claudiu
- Heuer Austin
- Hezam Kamal
- Hinneh Thomas Kwadwo
- Hiraike Yuta
- Hoan Nguyen Quoc
- Holla Ramesh
- Hon Julia
- Hoque Mohammad Enamul
- Horita Nobuyuki
- Hossain Sahadat
- Hosseini Seyed Ehsan
- Hosseinzadeh Hassan
- Hosseinzadeh Mehdi
- Hostiuc Mihaela
- Hostiuc Sorin
- Hoven Hanno
- Hsairi Mohamed
- Hsu Johnathan M
- Hu Chengxi
- Huang Junjie
- Huda Md Nazmul
- Hulland Erin N
- Hultström Michael
- Hushmandi Kiavash
- Hussain Javid
- Hussein Nawfal R
- Huynh Chantal K
- Huynh Hong-Han
- Ibitoye Segun Emmanuel
- Idowu Oluwatope Olaniyi
- Ihler Audrey L
- Ikeda Nayu
- Ikuta Kevin S
- Ilesanmi Olayinka Stephen
- Ilic Irena M
- Ilic Milena D
- Imam Mohammad Tarique
- Immurana Mustapha
- Inbaraj Leeberk Raja
- Irham Lalu Muhammad
- Isa Mustafa Alhaji
- Islam Md Rabiul
- Ismail Faisal
- Ismail Nahlah Elkudssiah
- Iso Hiroyasu
- Isola Gaetano
- Iwagami Masao
- Iwu Chidozie C D
- Iwu-Jaja Chinwe Juliana
- J Vinothini
- Jaafari Jalil
- Jacob Louis
- Jacobsen Kathryn H
- Jadidi-Niaragh Farhad
- Jahankhani Kasra
- Jahanmehr Nader
- Jahrami Haitham
- Jain Akhil
- Jain Nityanand
- Jairoun Ammar Abdulrahman
- Jaiswal Abhishek
- Jakovljevic Mihajlo
- Jalilzadeh Yengejeh Reza
- Jamora Roland Dominic G
- Jatau Abubakar Ibrahim
- Javadov Sabzali
- Javaheri Tahereh
- Jayaram Shubha
- Jeganathan Jayakumar
- Jeswani Bijay Mukesh
- Jiang Heng
- Johnson Catherine O
- Jokar Mohammad
- Jomehzadeh Nabi
- Jonas Jost B
- Joo Tamas
- Joseph Abel
- Joseph Nitin
- Joshi Vivek
- Joshua Charity Ehimwenma
- Jozwiak Jacek Jerzy
- Jürisson Mikk
- Kaambwa Billingsley
- Kabir Ali
- Kabir Zubair
- Kadashetti Vidya
- Kahn Ethan M
- Kalani Rizwan
- Kaliyadan Feroze
- Kalra Sanjay
- Kamath Rajesh
- Kanagasabai Thanigaivelan
- Kanchan Tanuj
- Kandel Himal
- Kanmiki Edmund Wedam
- Kanmodi Kehinde Kazeem
- Kansal Sushil Kumar
- Kapner Daniel John
- Kapoor Neeti
- Karagiannidis Efstratios
- Karajizadeh Mehrdad
- Karakasis Paschalis
- Karanth Shama D
- Karaye Ibraheem M
- Karch André
- Karim Asima
- Karimi Hanie
- Karmakar Shilpi
- Kashoo Faizan Zaffar
- Kasraei Hengameh
- Kassahun Woldeteklehaymanot Dagne
- Kassebaum Nicholas J
- Kassel Molly B
- Katikireddi Srinivasa Vittal
- Kauppila Joonas H
- Kawakami Norito
- Kaydi Neda
- Kayode Gbenga A
- Kazemi Foad
- Keiyoro Peter Njenga
- Kemmer Laura
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- Yi Siyan
- Yigzaw Zeamanuel Anteneh
- Yiğit Arzu
- Yin Dehui
- Yip Paul
- Yismaw Malede Berihun
- Yon Dong Keon
- Yonemoto Naohiro
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Zadey Siddhesh
- Zadnik Vesna
- Zakham Fathiah
- Zaki Nazar
- Zakzuk Josefina
- Zamagni Giulia
- Zaman Sojib Bin
- Zandieh Ghazal G Z
- Zanghì Aurora
- Zar Heather J
- Zare Iman
- Zarimeidani Fatemeh
- Zastrozhin Mikhail Sergeevich
- Zeng Youjie
- Zhai Chunxia
- Zhang Anthony Lin
- Zhang Haijun
- Zhang Liqun
- Zhang Meixin
- Zhang Yunquan
- Zhang Zhenyu
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhao Jeff T
- Zhao Xiu-Ju George
- Zhao Yang
- Zhao Yong
- Zheng Peng
- Zhong Chenwen
- Zhou Jingjing
- Zhou Juexiao
- Zhou Shangcheng
- Zhu Bin
- Zhu Lei
- Zhu Zhaohua
- Ziaeian Boback
- Ziafati Makan
- Zielińska Magdalena
- Zimsen Stephanie R M
- Zoghi Ghazal
- Zoller Thomas
- Zumla Alimuddin
- Zyoud Sa'ed H
- Zyoud Samer H
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Abbafati Cristiana
- Abbas Jaffar
- Abbasgholizadeh Rouzbeh
- Abbasi Madineh Akram
- Abbasian Mohammadreza
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdoun Meriem
- Abdullahi Auwal
- Abdurehman Ame Mehadi
- Abebe Mesfin
- Abedi Aidin
- Abedi Armita
- Abegaz Tadesse M
- Abeldaño Zuñiga Roberto Ariel
- Abhilash E S
- Abiodun Olugbenga Olusola
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abouzid Mohamed
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abrigo Michael R M
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Aburuz Salahdein
- Acuna Juan Manuel
- Adair Tim
- Addo Isaac Yeboah
- Adebayo Oladimeji M
- Adegboye Oyelola A
- Adekanmbi Victor
- Aden Bashir
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adeyeoluwa Temitayo Esther
- Adeyomoye Olorunsola Israel
- Adha Rishan
- Adibi Amin
- Adikusuma Wirawan
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afework Abel
- Afolabi Aanuoluwapo Adeyimika
- Afraz Ali
- Afyouni Shadi
- Afzal Saira
- Agasthi Pradyumna
- Aghamiri Shahin
- Agodi Antonella
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
- Ahmadzade Mohadese
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Ajumobi Olufemi
- Akalu Gizachew Taddesse
- Akara Essona Matatom
- Akinosoglou Karolina
- Akkala Sreelatha
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al Homsi Ammar
- Al Qadire Mohammad
- AL-Ahdal Tareq Mohammed Ali
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Eyadhy Ayman
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Jumaily Adel
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
- Al-Mekhlafi Hesham M
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Ala Moein
- Aladelusi Timothy Olukunle
- Alalalmeh Samer O
- Alam Khurshid
- Alam Manjurul
- Alam Zufishan
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albashtawy Mohammed
- AlBataineh Mohammad T
- Aldridge Robert W
- Alemi Sharifullah
- Alhabib Khalid F
- Alhalaiqa Fadwa Alhalaiqa Naji
- Ali Abid
- Ali Akhtar
- Ali Beriwan Abdulqadir
- Ali Hassam
- Ali Mohammed Usman
- Ali Rafat
- Ali Syed Shujait Shujait
- Ali Zahid
- Alian Samakkhah Shohreh
- Alicandro Gianfranco
- Alif Sheikh Mohammad
- Aligol Mohammad
- Alimi Rasoul
- Aliyi Ahmednur Adem
- Aljunid Syed Mohamed
- Almahmeed Wael
- Almazan Joseph Uy
- Almidani Omar
- Alomari Mahmoud A
- Alonso Nivaldo
- Alqahtani Jaber S
- Alqutaibi Ahmed Yaseen
- Altaf Awais
- Altirkawi Khalid A
- Alvi Farrukh Jawad
- Alwafi Hassan
- Aly Hany
- Alzoubi Karem H
- Amare Azmeraw T
- Ameyaw Edward Kwabena
- Amhare Abebe Feyissa
- Amin Tarek Tawfik
- Amindarolzarbi Alireza
- Aminian Dehkordi Javad
- Amiri Sohrab
- Amu Hubert
- Amugsi Dickson A
- Amzat Jimoh
- Ancuceanu Robert
- Anderlini Deanna
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Andrei Tudorel
- Angappan Dhanalakshmi
- Anil Abhishek
- Anjum Afifa
- Antony Catherine M
- Antriyandarti Ernoiz
- Anuoluwa Iyadunni Adesola
- Anwar Sumadi Lukman
- Anyasodor Anayochukwu Edward
- Appiah Seth Christopher Yaw
- Aqeel Muhammad
- Arab-Zozani Morteza
- Arabloo Jalal
- Arabzadeh Bahri Razman
- Arafat Mosab
- Araújo Ana Margarida
- Aravkin Aleksandr Y
- Aremu Abdulfatai
- Ariffin Hany
- Aripov Timur
- Armocida Benedetta
- Arooj Mahwish
- Artamonov Anton A
- Artanti Kurnia Dwi
- Arulappan Judie
- Aruleba Idowu Thomas
- Aruleba Raphael Taiwo
- Arumugam Ashokan
- Asaad Malke
- Asgary Saeed
- Ashemo Mubarek Yesse
- Ashraf Muhammad
- Asika Marvellous O
- Athari Seyyed Shamsadin
- Atout Maha Moh'd Wahbi
- Atreya Alok
- Attia Sameh
- Aujayeb Avinash
- Avan Abolfazl
- Awotidebe Adedapo Wasiu
- Ayala Quintanilla Beatriz Paulina
- Ayanore Martin Amogre
- Ayele Getnet Melaku
- Ayuso-Mateos Jose L
- Ayyoubzadeh Seyed Mohammad
- Azadnajafabad Sina
- Azhar Gulrez Shah
- Aziz Shahkaar
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- Baker Jennifer L
- Bakkannavar Shankar M
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- Balakrishnan Senthilkumar
- Balogun Saliu A
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- Banik Biswajit
- Banik Palash Chandra
- Bansal Hansi
- Barati Shirin
- Barchitta Martina
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- Basharat Zarrin
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- Bayileyegn Nebiyou Simegnew
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- Bhagat Devidas S
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- Biswas Atanu
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- Bitaraf Saeid
- Bjørge Tone
- Bleyer Archie
- Boampong Mary Sefa
- Bodolica Virginia
- Bodunrin Aadam Olalekan
- Bolarinwa Obasanjo Afolabi
- Bonakdar Hashemi Milad
- Bonny Aime
- Bora Basara Berrak
- Bora Kaustubh
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- Borschmann Rohan
- Botero Carvajal Alejandro
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- Boyko Edward J
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- Castañeda-Orjuela Carlos A
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- Chakraborty Chiranjib
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- Chang Chin-Kuo
- Charalampous Periklis
- Charan Jaykaran
- Chattu Vijay Kumar
- Chatzimavridou-Grigoriadou Victoria
- Chavula Malizgani Paul
- Cheema Huzaifa Ahmad
- Chen An-Tian
- Chen Haowei
- Chen Lingxiao
- Chen Meng Xuan
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- Cho So Mi Jemma
- Cho William C S
- Chong Bryan
- Chopra Hitesh
- Choudhary Rahul
- Chowdhury Rajiv
- Chu Dinh-Toi
- Chukwu Isaac Sunday
- Chung Eric
- Chung Eunice
- Chung Sheng-Chia
- Cini Karly I
- Clark Cain C T
- Coberly Kaleb
- Columbus Alyssa
- Comfort Haley
- Conde Joao
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- Costa Vera Marisa
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- Criqui Michael H
- Cruz-Martins Natália
- Culbreth Garland T
- Cullen Patricia
- Cunningham Matthew
- D'Amico Emanuele
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- Daneshvar Sara
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- Dashti Mohsen
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- De Leo Diego
- Debele Aklilu Tamire
- Degenhardt Louisa
- Dehbandi Reza
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- Delgado-Enciso Ivan
- Delgado-Ortiz Laura
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- Devanbu Vinoth Gnana Chellaiyan
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- Dhama Kuldeep
- Dhimal Mandira Lamichhane
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- Dias da Silva Diana
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- Dorsey E Ray
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- Ed-Dra Abdelaziz
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- Edvardsson David
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- El Arab Rabie Adel
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- Emeto Theophilus I
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- Eshetie Tesfahun C
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- Fadaka Adewale Oluwaseun
- Fagbamigbe Adeniyi Francis
- Fahimi Saman
- Falzone Luca
- Farinha Carla Sofia e Sá
- Faris MoezAlIslam Ezzat Mahmoud
- Farjoud Kouhanjani Mohsen
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- Ghassemi Fariba
- Ghazy Ramy Mohamed
- Ghimire Sailaja
- Gholamian Asadollah
- Gholamrezanezhad Ali
- Ghorbani Vajargah Pooyan
- Ghozali Ghozali
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- Gudeta Mesay Dechasa
- Guha Avirup
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- Gunawardane Damitha Asanga
- Gunturu Sasidhar
- Guo Cui
- Gupta Anish Kumar
- Gupta Bhawna
- Gupta Indarchand Ratanlal
- Gupta Rajat Das
- Gupta Sapna
- Gupta Veer Bala
- Gupta Vijai Kumar
- Gupta Vivek Kumar
- Gutiérrez Reyna Alma
- Habibzadeh Farrokh
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- Stefan Simona Cătălina
- Stein Dan J
- Steinbeis Fridolin
- Steiropoulos Paschalis
- Stockfelt Leo
- Stokes Mark A
- Stortecky Stefan
- Stranges Saverio
- Stroumpoulis Konstantinos
- Suleman Muhammad
- Suliankatchi Abdulkader Rizwan
- Sultana Abida
- Sun Jing
- Sunkersing David
- Susanty Sri
- Swain Chandan Kumar
- Sykes Bryan L
- Szarpak Lukasz
- Szeto Mindy D
- Szócska Miklós
- Šekerija Mario
- Tabaee Damavandi Payam
- Tabatabaei Malazy Ozra
- Tabatabaeizadeh Seyed-Amir
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- Tabb Karen M
- Tabish Mohammad
- Taborda-Barata Luis M
- Tabuchi Takahiro
- Tadesse Birkneh Tilahun
- Taheri Abkenar Yasaman
- Taheri Soodejani Moslem
- Taheri Amirmasoud
- Taherkhani Amir
- Taiba Jabeen
- Tajbakhsh Ardeshir
- Talaat Iman M
- Talukder Ashis
- Tamuzi Jacques Lukenze
- Tan Ker-Kan
- Tang Haosu
- Tang Hong K
- Tat Nathan Y
- Tat Vivian Y
- Tavakoli Oliaee Razieh
- Tavangar Seyed Mohammad
- Taveira Nuno
- Tebeje Tsion Mulat
- Tefera Yibekal Manaye
- Teimoori Mojtaba
- Temsah Mohamad-Hani
- Temsah Reem Mohamad Hani
- Teramoto Masayuki
- Tesfaye Solomon Hailemariam
- Thangaraju Pugazhenthan
- Thankappan Kavumpurathu Raman
- Thapa Rajshree
- Thapar Rekha
- Thomas Nihal
- Thrift Amanda G
- Thum Chern Choong Chern
- Tian Jing
- Tichopad Ales
- Ticoalu Jansje Henny Vera
- Tiruye Tenaw Yimer
- Tohidast Seyed Abolfazl
- Tonelli Marcello
- Touvier Mathilde
- Tovani-Palone Marcos Roberto
- Tram Khai Hoan
- Tran Nghia Minh
- Trico Domenico
- Trihandini Indang
- Tromans Samuel Joseph
- Truong Vien T
- Truyen Thien Tan Tri Tai
- Tsermpini Evangelia Eirini
- Tumurkhuu Munkhtuya
- Tung Kang
- Tyrovolas Stefanos
- Ubah Chukwudi S
- Udoakang Aniefiok John
- Udoh Arit
- Ulhaq Inam
- Ullah Saeed
- Ullah Sana
- Umair Muhammad
- Umar Tungki Pratama
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- Umesh Anushri
- Unim Brigid
- Unnikrishnan Bhaskaran
- Upadhyay Era
- Urso Daniele
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- Vahdani Amir Mohammad
- Vaithinathan Asokan Govindaraj
- Valadan Tahbaz Sahel
- Valizadeh Rohollah
- Van den Eynde Jef
- Varavikova Elena
- Varga Orsolya
- Varma Siddhartha Alluri
- Vart Priya
- Varthya Shoban Babu
- Vasankari Tommi Juhani
- Veerman Lennert J
- Venketasubramanian Narayanaswamy
- Venugopal Deneshkumar
- Verghese Nicholas Alexander
- Verma Madhur
- Verma Pratibha
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Vervoort Dominique
- Vieira Rafael José
- Villafañe Jorge Hugo
- Villani Leonardo
- Villanueva Gabriela Ines
- Villeneuve Paul J
- Violante Francesco S
- Visontay Rachel
- Vlassov Vasily
- Vo Bay
- Vollset Stein Emil
- Volovat Simona Ruxandra
- Volovici Victor
- Vongpradith Avina
- Vos Theo
- Vujcic Isidora S
- Vukovic Rade
- Wado Yohannes Dibaba
- Wafa Hatem A
- Waheed Yasir
- Wamai Richard G
- Wang Cong
- Wang Denny
- Wang Fang
- Wang Shu
- Wang Song
- Wang Yanzhong
- Wang Yuan-Pang
- Ward Paul
- Watson Stefanie
- Weaver Marcia R
- Weerakoon Kosala Gayan
- Weiss Daniel J
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- Wen Yi Feng
- Werdecker Andrea
- Westerman Ronny
- Wickramasinghe Dakshitha Praneeth
- Wickramasinghe Nuwan Darshana
- Wijeratne Tissa
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- Wojewodzic Marcin W
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- Woolf Anthony D
- Wu Dongze
- Wulandari Ratna Dwi
- Xiao Hong
- Xu Bin
- Xu Xiaoyue
- Yadav Lalit
- Yaghoubi Sajad
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Ye Pengpeng
- Yesera Gesila Endashaw
- Yesodharan Renjulal
- Yesuf Subah Abderehim
- Yiğit Arzu
- Yiğit Vahit
- Yip Paul
- Yon Dong Keon
- Yonemoto Naohiro
- You Yuyi
- Younis Mustafa Z
- Yu Chuanhua
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zahedi Mohammad
- Zahid Muhammad Nauman
- Zahir Mazyar
- Zakham Fathiah
- Zaki Nazar
- Zakzuk Josefina
- Zamagni Giulia
- Zaman Burhan Abdullah
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zandi Milad
- Zandieh Ghazal G Z
- Zanghì Aurora
- Zare Iman
- Zastrozhin Mikhail Sergeevich
- Zeariya Mohammed G M
- Zeng Youjie
- Zhai Chunxia
- Zhang Chen
- Zhang Haijun
- Zhang Hongwei
- Zhang Yunquan
- Zhang Zhaofeng
- Zhang Zhenyu
- Zhao Hanqing
- Zhao Yang
- Zhao Yong
- Zheng Peng
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Zhaohua
- Ziaeefar Pardis
- Zielińska Magdalena
- Zou Zhiyong
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdollahi Arash
- Abdullahi Auwal
- Abegaz Kedir Hussein
- Abeldaño Zuñiga Roberto Ariel
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abreu Lucas Guimarães
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abualruz Hasan
- Ackerman Ilana N
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adepoju Abiola Victor
- Adewuyi Habeeb Omoponle
- Afyouni Shadi
- Afzal Saira
- Afzal Sina
- Agodi Antonella
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Shahzaib
- Ahmed Ali
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ajami Marjan
- Akinosoglou Karolina
- Akkaif Mohammed Ahmed
- Al Hasan Syed Mahfuz
- Al-Aly Ziyad
- Al-Gheethi Adel Ali Saeed
- Al-Marwani Sabah
- Al-Omari Basem
- Al-Wardat Mohammad Sami
- Al-Worafi Yaser Mohammed
- Alalalmeh Samer O
- Albashtawy Mohammed
- Aldridge Robert W
- Alemu Meseret Desalegn
- Alemu Yihun Mulugeta
- Alene Kefyalew Addis
- Alharrasi Maryam
- Alhassan Robert Kaba
- Ali Mohammed Usman
- Ali Rafat
- Ali Syed Shujait Shujait
- Alif Sheikh Mohammad
- Aljunid Syed Mohamed
- Almazan Joseph Uy
- Alomari Mahmoud A
- Altaany Zaid
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J
- Alwafi Hassan
- Aly Safwat
- Alzoubi Karem H
- Amare Azmeraw T
- Amegbor Prince M
- Ameyaw Edward Kwabena
- Amin Tarek Tawfik
- Amindarolzarbi Alireza
- Amiri Sohrab
- Amugsi Dickson A
- Ancuceanu Robert
- Anderlini Deanna
- Anderson David B
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Ansari Hossein
- Antony Catherine M
- Anwar Saleha
- Anwar Sumadi Lukman
- Anwer Razique
- Anyanwu Philip Emeka
- Arab Juan Pablo
- Arabloo Jalal
- Arafat Mosab
- Araki Daniel T
- Aravkin Aleksandr Y
- Arkew Mesay
- Armocida Benedetta
- Arndt Michael Benjamin
- Arooj Mahwish
- Artamonov Anton A
- Aruleba Raphael Taiwo
- Arumugam Ashokan
- Ashbaugh Charlie
- Ashemo Mubarek Yesse
- Ashraf Muhammad
- Asika Marvellous O
- Askari Elaheh
- Astell-Burt Thomas
- Athari Seyyed Shamsadin
- Atorkey Prince
- Atout Maha Moh'd Wahbi
- Atreya Alok
- Aujayeb Avinash
- Ausloos Marcel
- Avan Abolfazl
- Awotidebe Adedapo Wasiu
- Awuviry-Newton Kofi
- Ayala Quintanilla Beatriz Paulina
- Ayuso-Mateos Jose L
- Azadnajafabad Sina
- Azevedo Rui M S
- Babu Abraham Samuel
- Badar Muhammad
- Badiye Ashish D
- Baghdadi Soroush
- Bagheri Nasser
- Bah Sulaiman
- Bai Ruhai
- Baker Jennifer L
- Bakkannavar Shankar M
- Bako Abdulaziz T
- Balakrishnan Senthilkumar
- Bam Kiran
- Banik Palash Chandra
- Barchitta Martina
- Bardhan Mainak
- Bardideh Erfan
- Barker-Collo Suzanne Lyn
- Barqawi Hiba Jawdat
- Barrow Amadou
- Barteit Sandra
- Barua Lingkan
- Bashiri Aliabadi Somaye
- Basiru Afisu
- Basu Sanjay
- Basu Saurav
- Bathini Prapthi Persis
- Batra Kavita
- Baune Bernhard T
- Bayileyegn Nebiyou Simegnew
- Behnam Babak
- Behnoush Amir Hossein
- Beiranvand Maryam
- Bejarano Ramirez Diana Fernanda
- Bell Michelle L
- Bello Olorunjuwon Omolaja
- Beloukas Apostolos
- Bensenor Isabela M
- Berezvai Zombor
- Bernabe Eduardo
- Bernstein Robert S
- Bettencourt Paulo J G
- Bhagavathula Akshaya Srikanth
- Bhala Neeraj
- Bhandari Dinesh
- Bhargava Ashish
- Bhaskar Sonu
- Bhat Vivek
- Bhatti Gurjit Kaur
- Bhatti Jasvinder Singh
- Bhatti Manpreet S
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- Bikbov Boris
- Bishai Jessica Devin
- Bisignano Catherine
- Bitra Veera R
- Bjørge Tone
- Bodolica Virginia
- Bodunrin Aadam Olalekan
- Bogale Eyob Ketema
- Bonakdar Hashemi Milad
- Bonny Aime
- Bora Basara Berrak
- Borhany Hamed
- Boxe Christopher
- Brady Oliver J
- Bragazzi Nicola Luigi
- Braithwaite Dejana
- Brant Luisa C
- Brauer Michael
- Breitner Susanne
- Brenner Hermann
- Brown Julie
- Brugha Traolach
- Bulamu Norma B
- Buonsenso Danilo
- Burkart Katrin
- Burns Richard A
- Busse Reinhard
- Bustanji Yasser
- Butt Zahid A
- Byun Justin
- Caetano dos Santos Florentino Luciano
- Calina Daniela
- Campos-Nonato Ismael R
- Cao Chao
- Capodici Angelo
- Carr Sinclair
- Carreras Giulia
- Carugno Andrea
- Carvalho Márcia
- Castaldelli-Maia Joao Mauricio
- Castañeda-Orjuela Carlos A
- Castelpietra Giulio
- Catapano Alberico L
- Cattaruzza Maria Sofia
- Caye Arthur
- Cámera Luis Alberto
- Cegolon Luca
- Cembranel Francieli
- Cenderadewi Muthia
- Cerin Ester
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- Chandika Rama Mohan
- Chandrasekar Eeshwar K
- Charalampous Periklis
- Chattu Vijay Kumar
- Chatzimavridou-Grigoriadou Victoria
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- Chen Catherine S
- Chen Haowei
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- Cheng Esther T W
- Chimed-Ochir Odgerel
- Chimoriya Ritesh
- Ching Patrick R
- Cho William C S
- Choi Sungchul
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- Chong Yuen Yu
- Choudhari Sonali Gajanan
- Chowdhury Rajiv
- Christensen Steffan Wittrup McPhee
- Chu Dinh-Toi
- Chukwu Isaac Sunday
- Chung Eric
- Chung Eunice
- Chutiyami Muhammad
- Claassens Mareli M
- Cogen Rebecca M
- Columbus Alyssa
- Conde Joao
- Cortesi Paolo Angelo
- Cousin Ewerton
- Criqui Michael H
- Cruz-Martins Natália
- D'Oria Mario
- Dadras Omid
- Dai Siyu
- Dai Xiaochen
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- Dalaba Maxwell Ayindenaba
- Damiani Giovanni
- Das Jai K
- Das Saswati
- Dashti Mohsen
- Davletov Kairat
- Dávila-Cervantes Claudio Alberto
- De Leo Diego
- Debele Aklilu Tamire
- Debopadhaya Shayom
- DeCleene Nicole K
- Deeba Farah
- Degenhardt Louisa
- Del Bo' Cristian
- Delgado-Enciso Ivan
- Demetriades Andreas K
- Denova-Gutiérrez Edgar
- Dervenis Nikolaos
- Desai Hardik Dineshbhai
- Desai Rupak
- Deuba Keshab
- Dhama Kuldeep
- Dharmaratne Samath Dhamminda
- Dhingra Sameer
- Dias da Silva Diana
- Diaz Daniel
- Diaz Luis Antonio
- Diaz Michael J
- Dima Adriana
- Ding Delaney D
- Dirac M Ashworth
- do Prado Camila Bruneli
- Do Thao Huynh Phuong
- Dohare Sushil
- Dominguez Regina-Mae Villanueva
- Dong Wanyue
- Dongarwar Deepa
- Dorsey E Ray
- Doshmangir Leila
- Dowou Robert Kokou
- Driscoll Tim Robert
- Dsouza Haneil Larson
- Dsouza Viola
- Dube John
- Dumith Samuel C
- Duncan Bruce B
- Duraes Andre Rodrigues
- Duraisamy Senbagam
- Durojaiye Oyewole Christopher
- Dzianach Paulina Agnieszka
- Dziedzic Arkadiusz Marian
- Eboreime Ejemai
- Ebrahimi Alireza
- Edinur Hisham Atan
- Edvardsson David
- Eikemo Terje Andreas
- Eini Ebrahim
- Ekholuenetale Michael
- Ekundayo Temitope Cyrus
- El Sayed Iman
- El Tantawi Maha
- Elbarazi Iffat
- Elemam Noha Mousaad
- ElGohary Ghada Metwally Tawfik
- Elhadi Muhammed
- Elmeligy Omar Abdelsadek Abdou
- ELNahas Gihan
- Elshaer Mohammed
- Elsohaby Ibrahim
- Engelbert Bain Luchuo
- Erkhembayar Ryenchindorj
- Eshrati Babak
- Estep Kara
- Fabin Natalia
- Fagbamigbe Adeniyi Francis
- Falzone Luca
- Fareed Mohammad
- Farinha Carla Sofia e Sá
- Faris MoezAlIslam Ezzat Mahmoud
- Faro Andre
- Farrokhi Pegah
- Fatehizadeh Ali
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- Feng Xiaoqi
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- Gaidhane Abhay Motiramji
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- Gebregergis Miglas W
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- Georgescu Simona Roxana
- Getachew Obsa Abera
- Gething Peter W
- Getie Molla
- Ghadiri Keyghobad
- Ghadirian Fataneh
- Ghailan Khalid Yaser
- Ghajar Alireza
- Ghasemi MohammadReza
- Ghasempour Dabaghi Ghazal
- Ghasemzadeh Afsaneh
- Ghazy Ramy Mohamed
- Gholamrezanezhad Ali
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- Ghotbi Elena
- Gibson Ruth Margaret
- Gill Tiffany K
- Ginindza Themba G
- Girmay Alem
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- Goharinezhad Salime
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- Golechha Mahaveer
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- Gorini Giuseppe
- Goulart Alessandra C
- Göbölös Laszlo
- Grada Ayman
- Grivna Michal
- Guan Shi-Yang
- Guarducci Giovanni
- Gubari Mohammed Ibrahim Mohialdeen
- Gudeta Mesay Dechasa
- Guha Avirup
- Guicciardi Stefano
- Gulati Snigdha
- Gulisashvili David
- Gunawardane Damitha Asanga
- Guo Cui
- Gupta Anish Kumar
- Gupta Bhawna
- Gupta Ishita
- Gupta Mohak
- Gupta Rajeev
- Gupta Veer Bala
- Gupta Vijai Kumar
- Gupta Vivek Kumar
- Gutiérrez Reyna Alma
- Habibzadeh Farrokh
- Habibzadeh Parham
- Haddadi Rasool
- Hadi Najah R
- Haep Nils
- Hafezi-Nejad Nima
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- Haller Sebastian
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- Hannan Md Abdul
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- Harapan Harapan
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- Hasaballah Ahmed I
- Hasan Ikramul
- Hasanian Mohammad
- Hasnain Md Saquib
- Hassan Amr
- Haubold Johannes
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- Hay Simon I
- Hayat Khezar
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- Hegazi Omar E
- Heidari Golnaz
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- Hemmati Mehdi
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- Hezam Kamal
- Hiraike Yuta
- Hoan Nguyen Quoc
- Holla Ramesh
- Hon Julia
- Hossain Md Mahbub
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- Hosseinzadeh Mehdi
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- Hostiuc Sorin
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- Huang Junjie
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- Imam Mohammad Tarique
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- Islam Md Rabiul
- Islam Sheikh Mohammed Shariful
- Islami Farhad
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- Iwu Chidozie C D
- Iyer Mahalaxmi
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- Jacobsen Kathryn H
- Jadidi-Niaragh Farhad
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- Jaggi Khushleen
- Jahankhani Kasra
- Jahanmehr Nader
- Jahrami Haitham
- Jain Akhil
- Jain Nityanand
- Jairoun Ammar Abdulrahman
- Jaiswal Abhishek
- Jakovljevic Mihajlo
- Jatau Abubakar Ibrahim
- Javadov Sabzali
- Javaheri Tahereh
- Jayapal Sathish Kumar
- Jayaram Shubha
- Jee Sun Ha
- Jeganathan Jayakumar
- Jeyakumar Angeline
- Jha Anil K
- Jiang Heng
- Jin Yinzi
- Jonas Jost B
- Joo Tamas
- Joseph Abel
- Joseph Nitin
- Joshua Charity Ehimwenma
- Jozwiak Jacek Jerzy
- Jürisson Mikk
- K Vaishali
- Kaambwa Billingsley
- Kabir Ali
- Kabir Zubair
- Kadashetti Vidya
- Kalani Rizwan
- Kalankesh Leila R
- Kaliyadan Feroze
- Kalra Sanjay
- Kamenov Kaloyan
- Kamyari Naser
- Kanagasabai Thanigaivelan
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- Yesuf Subah Abderehim
- Yezli Saber
- Yigzaw Zeamanuel Anteneh
- Yiğit Arzu
- Yiğit Vahit
- Yismaw Yazachew
- Yon Dong Keon
- Yonemoto Naohiro
- Younis Mustafa Z
- Yu Chuanhua
- Yu Yong
- Yusuf Hadiza
- Zahid Mondal Hasan
- Zakham Fathiah
- Zaki Leila
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- Zaman Burhan Abdullah
- Zamora Nelson
- Zand Ramin
- Zandieh Ghazal G Z
- Zar Heather J
- Zarrintan Armin
- Zastrozhin Mikhail Sergeevich
- Zhang Haijun
- Zhang Ning
- Zhang Yunquan
- Zhao Hanqing
- Zhong Chenwen
- Zhong Panliang
- Zhou Juexiao
- Zhu Zhaohua
- Ziafati Makan
- Zielińska Magdalena
- Zimsen Stephanie R M
- Zoladl Mohammad
- Zumla Alimuddin
- Zyoud Samer H
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation
Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
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- Konsten J. Van Heinsbergen M. (Viecuri Medisch Centrum). Nigeria: Olaogun J. (Ekiti State University Teaching Hospital)
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- Krdzic I. (Zvezdara University Medical Center). Singapore: Lieske B. (National University Hospital). South Africa: Almgla N.
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- Uludağ S. S.
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- Universiti Sains Malaysia)
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- Uslu G.
- Utkan N. Z.
- Uyanik M. S. (Samsun Training and Research Hospital)
- Uzunoglu F. G. (University Medical Center Hamburg–Eppendorf). Greece: Antonakis P.
- Vaccarella G. (Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello)
- Valbuena Jabares V. (Marqués de Valdecilla University Hospital)
- Valdes- Hernandez J. (Hospital Universitario Virgen Macarena)
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- Valle Rubio A. (Getafe University Hospital)
- Valverde S. (Hospital Clinic Barcelona)
- Van den Eynde J.
- Van den Eynde R. (Uz Leuven). Bulgaria: Sokolov M. (University Hospital Alexandrovska). Canada: Boutros M.
- Varma M. (University of California
- Vasljević J.
- Vassiliu P. (Attikon University General Hospital)
- Vaz Pereira R.
- Vaz S. (Centro Hospitalar e Universitário de São João)
- Velchuru V.
- Velickovic D. (Clinic for Digestive Surgery
- Velidedeoglu M.
- Venn M. (Royal London Hospital)
- Venskutonis D. (Lithuanian University of Health Sciences Kaunas Clinical Hospital). Madagascar: Rasoaherinomenjanahary F.
- Vera Mansilla C. (Hospital Universitario Principe de Asturias)
- Verberne C. (John Radcliffe Hospital)
- Vergari R. (Ospedali Riuniti di Ancona)
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- Vervoort D.
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- Vezakis A. (Aretaieion Hospital)
- Videira J. F. (IPO Porto). Réunion: Kassir R.
- Vieira B. (Centro Hospitalar de Trás-Os-Montes e Alto Douro
- Vieira Caroço T. (IPO Coimbra)
- Vieira Paiva Lopes A. C. (Hospital de Torres Vedras – Centro Hospitalar do Oeste)
- Vignali A. (San Raffaele Scientific Institute
- Vigorita V. (Álvaro Cunqueiro Hospital)
- Vijayan D. (Queen Elizabeth Hospital Birmingham)
- Villalabeitia Ateca I. (Hospital Universitario Cruces)
- Vimalachandran D. (Countess of Chester Hospital)
- Viswanath Y. K. S. (James Cook University Hospital)
- Vitali A. (Ospedale San Giovanni di Dio)
- Vitone L. (Royal Blackburn Hospital)
- Vives R. V. (Bellvitge University Hospital)
- Vo U. G. (Fiona Stanley Hospital)
- Von Papen M.
- Vovola F. (Ospedali Riuniti Azienda Ospedaliera Universitaria Foggia)
- Vucic N.
- Vázquez Fernández A. (Hospital Clínico Universitario de Valladolid)
- Wadham B. (The University Hospital of South Manchester)
- Walkes K. (Queen Elizabeth Hospital). Belgium: Flamey N.
- Wani R. (Sher-I-Kashmir Institute of Medical Sciences)
- Waqar S. H. (Pakistan Institute of Medical Sciences). Poland: Major P. (Jagiellonian University Medical College). Portugal: Azevedo C.
- Warren O. (Chelsea and Westminster Hospital)
- Watson L. J. (Sunderland Royal Hospital)
- Watson N. (King’s Mill Hospital)
- Weitz J.
- Welsch T. (Carl-Gustav-Carus University Hospital
- Werner J. (LMU Klinikum Campus Innenstadt)
- Westwood E. (James Paget University NHS Foundation Trust Hospital)
- Whelan M. (Tallaght University Hospital)
- Whitmore H. (Torbay and South Devon NHS Trust)
- Wilkin R. J. W. (South Warwickshire NHS Foundation Trust)
- Wilkins A. (Hull University Teaching Hospitals NHS Trust)
- Williams G. (Royal Gwent Hospital)
- Williams K. (St George’s Hospital)
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- Wimmer A. (Paracelsus Medical University Salzburg). Barbados: Barker D.
- Wong M.
- Worku D. (Queens Medical Centre)
- Wullschleger M. (Gold Coast University Hospital)
- Xavier R. G.
- Xenaki S.
- Xynos E. (University Hospital of Heraklion Crete and Interclinic Hospital of Crete). Hong Kong: Futaba K.
- Yang W.
- Yassin N. (Royal Wolverhampton NHS Trust)
- Ye G.
- Yesantharao P.
- Yetkin S. G. (Sisli Hamidiye Etfal Training and Research Hospital)
- Yeşilyurt D. (University of Health Sciences Tepecik Training and Research Hospital)
- Yiallourou A. (Nicosia General Hospital). Czechia: Martinek L.
- Yıldırım A.
- Yildiz A. (Yildirim Beyazit University Yenimahalle Training and Research Hospital). Uganda: Lule H.
- Young R. (York Teaching Hospitals NHS Trust)
- Yousof E. A. (Assiut University Hospital)
- Youssef M. (Norfolk and Norwich University Hospital)
- Yurttas C. (University Hospital Tuebingen)
- Yánez C. (Royo Villanova)
- Yüksel E. (Kocaeli University Teaching Hospital)
- Zafar S. N. (University of Wisconsin)
- Zakaria A. D.
- Zakaria Z. (School of Medical Sciences and Hospital
- Zambon M. (Policlinico Umberto I Sapienza University of Rome)
- Zanus G. (Ca’ Foncello Treviso – DISCOG – Università di Padova)
- Zegarac M. (Institute for Oncology and Radiology of Serbia)
- Zelić M. (University Hospital Center Rijeka)
- Zengin A. K. (Istanbul Universty – Cerrahpaşa Medical Faculty)
- Zerbib P. (CHU Lille)
- Zervas K.
- Zese M. (Santa Maria degli Angeli Hospital ULSS 5 – Adria)
- Zhang H. (Concord Repatriation General Hospital)
- Zizzo M. (Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia)
- Zografos C. (Laiko University Hospital)
- Zorrilla Ortúzar J. (Hospital General Universitario Gregorio Marañón)
- Zourntou S. (General Hospital of Larissa ‘Koutlimpaneio and Triantafylleio’)
- Zubaidi A. M. (King Saud University). Serbia: Aleksić L.
- Ângelo M.
- Çelebi F.
- Çolak E.
- Öfner D. (Medical University of Innsbruck)
- Öhlberger L.
- Özçelık M. F.
- Öğücü H.
- Überrück L.
- Ćoza I.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic
Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study
- Author
- Aawsaj Y.
- Abad Gurumeta A.
- Abad-Motos A.
- Abate E.
- Abatini C.
- Abbadessa F.
- Abbas A. M.
- Abbassi-Ghadi N.
- Abbott D.
- Abbott T.
- Abd Elazeem H. A. S.
- Abdalla M.
- Abdallah M.
- Abdel Al S.
- Abdel Jalil R.
- Abdeldayem H.
- Abdelkader Salama I.
- Abdelkarem M. M.
- Abdelkarim M.
- Abdelmajeed A.
- Abdelrahman A.
- Abdelrahman S.
- Abdelsamed A.
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- Abdulkareem A.
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- 'American Society of Clinical Oncology (ASCO)'
- Publication date
- 01/01/2021
- Field of study
PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
- Author
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- Publication venue
- J Clin Oncol
- Publication date
- 01/01/2020
- Field of study
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Abate Yohannes Habtegiorgis
- Abbas Jaffar
- Abbasi Madineh Akram
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd-Rabu Rami
- Abdelmasseh Michael
- Abdollahi Mohammad
- Abdollahi Mozhan
- Abdollahifar Mohammad-Amin
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abedi Aidin
- Abedi Vida
- Abeldaño Zuñiga Roberto Ariel
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Aboyans Victor
- Abrha Woldu Aberhe
- Abu-Gharbieh Eman
- Abualhasan Ahmed
- Aburuz Salahdein
- Adamu Lawan Hassan
- Addo Isaac Yeboah
- Adebayo Oladimeji M
- Adekanmbi Victor
- Adekiya Tayo Alex
- Adikusuma Wirawan
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afework Tsion
- Afolabi Aanuoluwapo Adeyimika
- Afraz Ali
- Afzal Saira
- Aghamiri Shahin
- Agodi Antonella
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Sajjad
- Ahmadzade Amir Mahmoud
- Ahmed Ali
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Jivan Qasim
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Ajumobi Olufemi
- Akade Seyed Esma'il
- Akbari Morteza
- Akbarialiabad Hossein
- Akhlaghi Shiva
- Akinosoglou Karolina
- Akinyemi Rufus Olusola
- Akonde Maxwell
- Al Hasan Syed Mahfuz
- AL-Ahdal Tareq Mohammed Ali
- Al-amer Rasmieh Mustafa
- Al-Gheethi Adel Ali Saeed
- Al-Omari Basem
- Al-Shahi Salman Rustam
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- Saadatian Zahra
- Saber Korosh
- SaberiKamarposhti Morteza
- Sacco Simona
- Saddik Basema
- Sadeghi Erfan
- Sadeghian Saeid
- Saeed Umar
- Saeed Usman
- Safdarian Mahdi
- Safi Sher Zaman
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- Sagoe Dominic
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- Saheb Sharif-Askari Narjes
- Sahebkar Amirhossein
- Sahoo Soumya Swaroop
- Sahraian Mohammad Ali
- Sajedi Seyed Aidin
- Sakshaug Joseph W
- Saleh Mohamed A
- Salehi Omran Hossein
- Salem Marwa Rashad
- Salimi Sohrab
- Samadi Kafil Hossein
- Samadzadeh Sara
- Samargandy Saad
- Samodra Yoseph Leonardo
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- Samy Abdallah M
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- Shabani Mohammad
- Shabany Maryam
- Shafie Mahan
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- Shahid Samiah
- Shahraki-Sanavi Fariba
- Shahsavari Hamid R
- Shahwan Moyad Jamal
- Shaikh Masood Ali
- Shaji KS
- Sham Sunder
- Shama Adisu Tafari T
- Shamim Muhammad Aaqib
- Shams-Beyranvand Mehran
- Shamsi Mohammad Anas
- Shanawaz Mohd
- Sharath Medha
- Sharfaei Sadaf
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- Sharma Manoj
- Sharma Rajesh
- Shashamo Bereket Beyene
- Shayan Maryam
- Sheikhi Rahim Ali
- Shekhar Shashank
- Shen Jiabin
- Shenoy Suchitra M
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- Shigematsu Mika
- Shiri Rahman
- Shittu Aminu
- Shivakumar K M
- Shokri Fereshteh
- Shool Sina
- Shorofi Seyed Afshin
- Shrestha Sunil
- Siankam Tankwanchi Akhenaten Benjamin
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- Silva Luís Manuel Lopes Rodrigues
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- Suleman Muhammad
- Suliankatchi Abdulkader Rizwan
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- Sunny Angel
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- Swain Chandan Kumar
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- Tabatabai Shima
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- Truelsen Thomas Clement
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- Tsatsakis Aristidis
- Tsegay Guesh Mebrahtom
- Tsermpini Evangelia Eirini
- Tualeka Abdul Rohim
- Tufa Derara Girma
- Ubah Chukwudi S
- Udoakang Aniefiok John
- Ulhaq Inam
- Umair Muhammad
- Umakanthan Srikanth
- Umapathi Krishna Kishore
- Unim Brigid
- Unnikrishnan Bhaskaran
- Vaithinathan Asokan Govindaraj
- Vakilian Alireza
- Valadan Tahbaz Sahel
- Valizadeh Rohollah
- Van den Eynde Jef
- Vart Priya
- Varthya Shoban Babu
- Vasankari Tommi Juhani
- Vaziri Siavash
- Vellingiri Balachandar
- Venketasubramanian Narayanaswamy
- Verras Georgios-Ioannis
- Vervoort Dominique
- Villafañe Jorge Hugo
- Villani Leonardo
- Vinueza Veloz Andres Fernando
- Viskadourou Maria
- Vladimirov Sergey Konstantinovitch
- Vlassov Vasily
- Volovat Simona Ruxandra
- Vos Theo
- Vu Loc Tri
- Vujcic Isidora S
- Wagaye Birhanu
- Waheed Yasir
- Wahood Waseem
- Walde Mandaras Tariku
- Wang Fang
- Wang Shu
- Wang Yanzhong
- Wang Yuan-Pang
- Waqas Muhammad
- Waris Abdul
- Weerakoon Kosala Gayan
- Weintraub Robert G
- Weldemariam Abrha Hailay
- Westerman Ronny
- Whisnant Joanna L
- Wickramasinghe Dakshitha Praneeth
- Wickramasinghe Nuwan Darshana
- Willekens Barbara
- Wilner Lauren B
- Winkler Andrea Sylvia
- Wolfe Charles D A
- Wu Ai-Min
- Wulf Hanson Sarah
- Xu Suowen
- Xu Xiaoyue
- Yadollahpour Ali
- Yaghoubi Sajad
- Yahya Galal
- Yamagishi Kazumasa
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Yehualashet Sisay Shewasinad
- Yeshaneh Alex
- Yesiltepe Metin
- Yi Siyan
- Yiğit Arzu
- Yiğit Vahit
- Yon Dong Keon
- Yonemoto Naohiro
- You Yuyi
- Younis Mustafa Z
- Yu Chuanhua
- Yusuf Hadiza
- Zadey Siddhesh
- Zahedi Mohammad
- Zakham Fathiah
- Zaki Nazar
- Zali Alireza
- Zamagni Giulia
- Zand Ramin
- Zandieh Ghazal G Z
- Zangiabadian Moein
- Zarghami Amin
- Zastrozhin Mikhail Sergeevich
- Zeariya Mohammed G M
- Zegeye Zelalem Banjaw
- Zeukeng Francis
- Zhai Chunxia
- Zhang Chen
- Zhang Haijun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhao Yang
- Zheng Peng
- Zhou Hengxing
- Zhu Bin
- Zhumagaliuly Abzal
- Zielińska Magdalena
- Zikarg Yossef Teshome
- Zoladl Mohammad
- Ärnlöv Johan
- Publication venue
- Elsevier
- Publication date
- 01/04/2024
- Field of study
BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Ababneh Hazim S
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abedi Aidin
- Abegaz Kedir Hussein
- Abhilash E S
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Aburuz Salahdein
- Accrombessi Manfred Mario Kokou
- Adal Tadele Girum
- Adamu Abdu A
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adekanmbi Victor
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Admass Biruk Adie Adie
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Aanuoluwapo Adeyimika
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agasthi Pradyumna
- Aggarwal Manik
- Aghamiri Shahin
- Agide Feleke Doyore
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Sajjad
- Ahmad Shahzaib
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
- Ahmed Ali
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Mehrunnisha Sharif
- Ahmed Meqdad Saleh
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Akara Essona Matatom
- Akbarialiabad Hossein
- Akinosoglou Karolina
- Akinyemiju Tomi
- Akkaif Mohammed Ahmed
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Azzam Sayer
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
- Al-Mekhlafi Hesham M
- Al-Omari Basem
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Alahdab Fares
- Alalalmeh Samer O
- Alalwan Tariq A
- Alam Khurshid
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- Alam Noore
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albakri Almaza
- Albashtawy Mohammed
- AlBataineh Mohammad T
- Alcalde-Rabanal Jacqueline Elizabeth
- Aldawsari Khalifah A
- Aldhaleei Wafa A
- Aldridge Robert W
- Alema Haileselasie Berhane
- Alemayohu Mulubirhan Assefa
- Alemi Sharifullah
- Alemu Yihun Mulugeta
- Alhabib Khalid F
- Alhalaiqa Fadwa Alhalaiqa Naji
- Ali Abid
- Ali Amjad
- Ali Liaqat
- Ali Mohammed Usman
- Ali Rafat
- Ali Shahid
- Ali Syed Shujait Shujait
- Alicandro Gianfranco
- Alif Sheikh Mohammad
- Alikhani Reyhaneh
- Alimohamadi Yousef
- Aliyi Ahmednur Adem
- Aljasir Mohammad A M
- Aljunid Syed Mohamed
- Alla François
- Allebeck Peter
- Almazan Joseph Uy
- Almidani Louay
- Almidani Omar
- Alomari Mahmoud A
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- Alqahtani Jaber S
- Alqalyoobi Shehabaldin
- Alqutaibi Ahmed Yaseen
- Altaany Zaid
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- Amugsi Dickson A
- Amusa Ganiyu Adeniyi
- Ancuceanu Robert
- Anderlini Deanna
- Anderson David B
- Andrade Pedro Prata
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- Andrei Tudorel
- Angus Colin
- Anil Abhishek
- Anil Sneha
- Anoushiravani Amir
- Ansari Hossein
- Ansari-Moghaddam Alireza
- Ansariadi Ansariadi
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- Antriyandarti Ernoiz
- Anvari Davood
- Anvari Saeid
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- Anwar Sumadi Lukman
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- Arab Juan Pablo
- Arabloo Jalal
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- Areda Demelash
- Aremu Abdulfatai
- Aremu Olatunde
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- Arkew Mesay
- Armocida Benedetta
- Arndt Michael Benjamin
- Arooj Mahwish
- Artamonov Anton A
- Arulappan Judie
- Aruleba Raphael Taiwo
- Arumugam Ashokan
- Asaad Malke
- Asadi-Lari Mohsen
- Asgedom Akeza Awealom
- Asghari-Jafarabadi Mohammad
- Asghariahmadabad Mona
- Ashraf Muhammad
- Aslani Armin
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- Athar Mohammad
- Athari Seyyed Shamsadin
- Atinafu Bantalem Tilaye Tilaye
- Atlaw Habtamu Wondmagegn
- Atorkey Prince
- Atout Maha Moh'd Wahbi
- Atreya Alok
- Aujayeb Avinash
- Ausloos Marcel
- Avan Abolfazl
- Awedew Atalel Fentahun
- Aweke Amlaku Mulat
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- B Darshan B
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- Baghdadi Soroush
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- Bako Abdulaziz T
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- Bansal Hansi
- Bansal Kannu
- Barbic Franca
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- Barone-Adesi Francesco
- Barqawi Hiba Jawdat
- Barrero Lope H
- Barrow Amadou
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- Barua Lingkan
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- Bayati Mohsen
- Bayileyegn Nebiyou Simegnew
- Beaney Thomas
- Bedi Neeraj
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- Behzadifar Masoud
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- Bejarano Ramirez Diana Fernanda
- Belay Sefealem Assefa
- Belete Chalie Mulu
- Bell Michelle L
- Bello Muhammad Bashir
- Bello Olorunjuwon Omolaja
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- Beloukas Apostolos
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- Bhagat Devidas S
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- Bhardwaj Prarthna V
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- Bhatti Jasvinder Singh
- Bhatti Manpreet S
- Bhatti Rajbir
- Bhutta Zulfiqar A
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- Bishai Jessica Devin
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- Biswas Atanu
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- Bitra Veera R
- Bjørge Tone
- Boachie Micheal Kofi
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- Bobirca Anca Vasilica
- Bodolica Virginia
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- Bogale Kassawmar Angaw
- Bohlouli Somayeh
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- Bonny Aime
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- Brenner Hermann
- Briko Andrey Nikolaevich
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- Bustanji Yasser
- Butt Nadeem Shafique
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- Bärnighausen Till Winfried
- Béjot Yannick
- Caetano dos Santos Florentino Luciano
- Calina Daniela
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- Cao Chao
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- Charalampous Periklis
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- Chaturvedi Pankaj
- Chatzimavridou-Grigoriadou Victoria
- Chaurasia Akhilanand
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- Chen Meng Xuan
- Chen Simiao
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- Cheng Esther T W
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- Chimed-Ochir Odgerel
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- Chung Eric
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- Yang Danting
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- Yao Yao
- Yaribeygi Habib
- Ye Pengpeng
- Yehualashet Sisay Shewasinad
- Yesiltepe Metin
- Yesuf Subah Abderehim
- Yezli Saber
- Yi Siyan
- Yigezu Amanuel
- Yip Paul
- Yismaw Malede Berihun
- Yismaw Yazachew
- Yiğit Arzu
- Yiğit Vahit
- Yon Dong Keon
- Yonemoto Naohiro
- Yoon Seok-Jun
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuh Faith H
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zangiabadian Moein
- Zar Heather J
- Zare Iman
- Zarrintan Armin
- Zeariya Mohammed G M
- Zeinali Zahra
- Zhang Haijun
- Zhang Jianrong
- Zhang Jingya
- Zhang Liqun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Ziafati Makan
- Zielińska Magdalena
- Zitoun Osama A
- Zoladl Mohammad
- Zou Zhiyong
- Zuhlke Liesl J
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Ärnlöv Johan
- Šekerija Mario
- Publication venue
- Elsevier
- Publication date
- 01/01/2024
- Field of study
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
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