Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Management of critically ill septic patients with diabetes

Diabetes and sepsis are major contributors of morbidity and mortality around the world, with diabetic patients accounting for the majority of post-sepsis comorbidities and escalating mortality rates. Diabetes is undoubtedly a key comorbid syndrome due to its high frequency and propensity to affect critical parts of sepsis pathogenesis; however, the precise impact of diabetes on infection and sepsis progression is elusive. In diabetic individuals with sepsis, dysfunctional immunological pathways, which are frequent in both sepsis and diabetes, promotes worsening of the host response. The effect of diabetes on sepsis mortality is still debatable. While poor glycemic management is linked to the incidence of a large proportion of severe infections, treatment with insulin or commercially available oral antidiabetic drugs are linked to lower sepsis incidence and even death. Optimal glycemic control has been reported to improve immunological adaptability, resulting in a lower mortality rate in diabetes patients with sepsis. The present review is an attempt to gather literature pertinent to glycemic control and risk of sepsis. An additional body of reports are also included on the effect of insulin and other anti-diabetic medications on the incidence and mortality for sepsis along with the strategies employed for the management of the said illness.

Analysis to Assess the Prevalence and Causes of Low Back Pain in a Known Population at a Tertiary Care Hospital

Background:Low back pain (LBP) is a significant health issue in all developing nations. It is also the most frequently treated health issue in healthcare sector. Hence; the present study was undertaken for assessing the prevalence and causes of low back pain in a known population.Materials & Methods: A total of 500 patients who reported to the Department of Orthopedics, S.P. Medical College and Associated Groups of P.B.M. Hospitals, Bikaner, Rajasthan (India) were enrolled. Complete demographic data of all the patients was obtained. Thorough clinical and medical history of all the patients was assessed. Chief complaint was recorded and radiographic examination of all the patients was done. Diagnosis of low back pain was established and prevalence of CLB pain was recorded. A Performa was framed and various etiologic factors of CLB were assessed.Results: Overall prevalence of LBP was 42.4 percent. Lumbar herniated disc was present in 11.79 percent of the patients while degenerative disc disease was present in 13.68 percent of the patients. Spinal stenosis and osteoarthritis were seen in 16.04 percent and 13.21 percent of the patients respectively. Tumour and compression fracture were seen in 10.38 percent and 8.49 percent of the patients.Conclusion: LBP is a significant health issue affecting major proportion of world’s population. Degenerative disc disease, Spinal stenosis and Osteoarthritis are the major factor responsible for its occurrence

To Find Out the Incidence of Osteoporosis Among Smokers: An Institutional Based Study

Background: Osteoporosis is a complex heterogeneous disorder. Smoking is well known to cause various health problems, including osteoporosis and bone fracture. Hence; the present study was undertaken for assessing the incidence of osteoporosis among smokers.Materials &Methods: A total of 500 smokers with smoking history of minimum of 10 cigarettes per day for a minimum of past 5 years were included. Also, a total of 500 normal controls (non-smokers) were also enrolled. Complete demographic and clinical data of all the patients was obtained. Detailed medical and personal history of all the subjects was also recorded. Thorough clinical and oral examination of all the subjects was done. Incidence of osteoporosis was also recoded. Results: Overall incidence of osteoporosis among smokers and non-smokers was 31.6 percent and 4.2 percent respectively. Incidence of osteoporosis was significantly higher in smokers in comparison to non-smokers. In the smoker’s group, 50.63 percent of the patients with osteoporosis belonged to the age group of more than 45 years while 34.81 percent of the patients belonged to the age group of 30 to 45 years. In the non-smokers group, 47.62 percent of the patients with osteoporosis belonged to the age group of more than 45 years while 38.09 percent of the patients belonged to the age group of 30 to 45 years. In the smokers and non-smokers group, 66.46 percent and 61.91 percent of the patients with osteoporosis were females.Conclusion: Smoking is a significant risk factor for osteoporosis. Keywords: Osteoporosis, Smokers

Estimating global injuries morbidity and mortality:methods and data used in the Global Burden of Disease 2017 study

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future. </p

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. W measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. Interpretation Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young