65 research outputs found
Handwritten Signature Verification using Deep Learning
- Author
- Publication venue
- Publication date
- 01/01/2020
- Field of study
Every person has his/her own unique signature that is used mainly for the purposes of personal
identification and verification of important documents or legal transactions. There are two kinds of signature
verification: static and dynamic. Static(off-line) verification is the process of verifying an electronic or document
signature after it has been made, while dynamic(on-line) verification takes place as a person creates his/her
signature on a digital tablet or a similar device. Offline signature verification is not efficient and slow for a large
number of documents. To overcome the drawbacks of offline signature verification, we have seen a growth in
online biometric personal verification such as fingerprints, eye scan etc. In this paper we created CNN model
using python for offline signature and after training and validating, the accuracy of testing was 99.70%
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
- Author
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
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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
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.
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- Publication venue
- '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
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
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- Ávila C.C.
- Älgå A.
- Çakıcı MÇ
- Çelik E.
- Çelik M.N.
- Özçay N.
- Şevi̇k H.
- Šantak G.
- Šimko K.
- Žatecký J.
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 01/07/2023
- Field of study
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
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
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- 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
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- Antonazzo Ippazio Cosimo
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- 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
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- 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
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- Bai Ruhai
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- Baltatu Ovidiu Constantin
- Bam Kiran
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- Banik Biswajit
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- Bansal Hansi
- Barchitta Martina
- Bardhan Mainak
- Bardideh Erfan
- Barker-Collo Suzanne Lyn
- Barone-Adesi Francesco
- Barqawi Hiba Jawdat
- Barrero Lope H
- Barrow Amadou
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- Basharat Zarrin
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- 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
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- 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
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- 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
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- ElGohary Ghada Metwally Tawfik
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- 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
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- Feng Xiaoqi
- Fereshtehnejad Seyed-Mohammad
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- Ferrara Pietro
- Ferrari Alize J
- Ferreira Nuno
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- Filip Irina
- Fischer Florian
- Fitriana Ida
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- Flood David
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- Franklin Richard Charles
- Freitas Alberto
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- Gaihre Santosh
- Gajdács Márió
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- Gandhi Aravind P
- Ganesan Balasankar
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- Gebregergis Miglas W
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- Ghaffari Jolfayi Amir
- Ghailan Khalid Yaser
- Ghajar Alireza
- Ghasemi MohammadReza
- Ghasempour Dabaghi Ghazal
- Ghasemzadeh Afsaneh
- Ghassemi Fariba
- Ghazy Ramy Mohamed
- Gholami Ali
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- Gil Gabriela Fernanda
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- Graham Simon Matthew
- Grivna Michal
- Grosso Giuseppe
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- 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
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- Gupta Vivek Kumar
- Habibzadeh Farrokh
- Habibzadeh Parham
- Hadaro Tesfahun Simon
- Hadian Zahra
- Haep Nils
- Haghi-Aminjan Hamed
- Haghmorad Dariush
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- Hailu Alemayehu
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- Halboub Esam S
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- Hammoud Ahmad
- Hanif Asif
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- Haq Zaim Anan
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- Harapan Harapan
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- 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
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- Hassani Shokoufeh
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- Hay Simon I
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- Hegazi Omar E
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- 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
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- Hostiuc Mihaela
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- Hoven Hanno
- Hsairi Mohamed
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- Hu Chengxi
- Huang Junjie
- Huda Md Nazmul
- Hulland Erin N
- Hultström Michael
- Hushmandi Kiavash
- Hussain Javid
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- Idowu Oluwatope Olaniyi
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- Ikeda Nayu
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- Ilesanmi Olayinka Stephen
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- Imam Mohammad Tarique
- Immurana Mustapha
- Inbaraj Leeberk Raja
- Irham Lalu Muhammad
- Isa Mustafa Alhaji
- Islam Md Rabiul
- Ismail Faisal
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- Iso Hiroyasu
- Isola Gaetano
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- Iwu Chidozie C D
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- 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
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- Jokar Mohammad
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- 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
- Kempen John H
- Kerr Jessica A
- Kesse-Guyot Emmanuelle
- Khader Yousef Saleh
- Khafaie Morteza Abdullatif
- Khajuria Himanshu
- Khalaji Amirmohammad
- Khalil Mariam
- Khalilian Alireza
- Khamesipour Faham
- Khan Asaduzzaman
- Khan M Nuruzzaman
- Khan Maseer
- Khan Mohammad Jobair
- Khan Moien AB
- Khanmohammadi Shaghayegh
- Khatab Khaled
- Khatatbeh Haitham
- Khatatbeh Moawiah Mohammad
- Khatib Mahalaqua Nazli
- Khavandegar Armin
- Khayat Kashani Hamid Reza
- Khidri Feriha Fatima
- Khodadoust Elaheh
- Khormali Moein
- Khorrami Zahra
- Khosla Atulya Aman
- Khosrowjerdi Mahmood
- Khreis Haneen
- Khusun Helda
- Kifle Zemene Demelash
- Kim Kwanghyun
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- 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
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- Altirkawi Khalid A
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- 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
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- Angappan Dhanalakshmi
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- Anjum Afifa
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- Antriyandarti Ernoiz
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- Aruleba Idowu Thomas
- Aruleba Raphael Taiwo
- Arumugam Ashokan
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- Ashemo Mubarek Yesse
- Ashraf Muhammad
- Asika Marvellous O
- Athari Seyyed Shamsadin
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- Attia Sameh
- Aujayeb Avinash
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- 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
- Umeokonkwo Chukwuma David
- Umesh Anushri
- Unim Brigid
- Unnikrishnan Bhaskaran
- Upadhyay Era
- Urso Daniele
- Vacante Marco
- 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
- Weldemariam Abrha Hailay
- Wells Katherine M
- Wen Yi Feng
- Werdecker Andrea
- Westerman Ronny
- Wickramasinghe Dakshitha Praneeth
- Wickramasinghe Nuwan Darshana
- Wijeratne Tissa
- Wilson Shadrach
- Wojewodzic Marcin W
- Wool Eve E
- 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
Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
- Author
- Abbas Ahmed Hosam Eldin Hasan
- Abbas Ghanem
- Abbas Hazem
- Abbatini Francesca
- Abdalbakheet Duaa
- Abdallah Emad
- Abdelazim Tarek
- Abdelaziz Nabil Yassin Tammam
- Abdelglil Momen
- Abdelhalim Ahmed
- Abdelhalim Mostafa Mohammed
- Abdelhamid Ahmed
- Abdelhamid Mohamed Sayed
- Abdelkhalik Morsi Mohamed Morsi
- Abdellatif Ahmed
- Abdelmageed Mohammed Elkassaby
- Abdelmaksoud Mohamed
- Abdelmohsen Ahmed
- Abdelmomen Ahmed Ezzat Elghrieb
- Abdelmoneim Ibrahim Tharwat Mohamed
- Abdelmonem Mohamed Ahmed
- Abdelmotaleb Hussien Ali
- Abdelrafee Ahmed
- Abdelrasheed Sayed
- Abdelsayed Emad Fahim
- Abdo Nael
- Abdulatef Shehab Ahmed Ali
- Abdullah Alqahtani Ali
- Abdulrahman Chadi
- Abdur-Rahman Lukman
- Abduraboh Abdullah Fayez
- Abed Ali Ibrahim Eldawy
- Abiodun Azeez Lateef
- Abiyere Henry
- Aboelmagid Hamdy Haggag Ebrahim
- Abolnasr Khaled Samir
- Abosi-Appeadu Kessewa
- Abouelnagah Galal
- Abozeid Ahmad Mahmoud
- Abozeid Mahmoud
- Abualkhair Wael
- Abualnaja Yousra
- Abualsel Abdulmenem
- Abuosba Abdelrahman
- Abusalem Osama
- Abusiam Wael
- Abutalib Raid Abdullah
- Abuzeid Mohamed Mostafa
- Addari Giulio
- Adebowale Yusuf
- Adejumo Adeyinka
- Adel Mohammed
- Adeoluwa Ojajuni
- Adeyeye Ademola
- Adly Ramy Magdy
- Adorisio Ottavio
- Agbonrofo Peter
- Agrawal Abhishek
- Ahmad Farooq
- Ahmad Misbahu Haruna
- Ahmad Mustafa
- Ahmad Sufian
- Ahmad Suhaib
- Ahmed Abeer Abdul Hameed
- Ahmed Arooj
- Ahmed Emad Ali
- Ahmed Hassan
- Ahmed Mohamed
- Ahmed Mostafa Mahmoud
- Aitali Abdelmounaim
- Akeel Nouf
- Akhtar Khalid
- Akin Furkan Atakan
- Akinmade Akinola
- Al Eisa Abdulmohsen
- Al Hassn Ibrahim
- Al Naeb Mohamed
- Al Turki Neamat Ahmed Ali
- Al-Bahrani Ahmed
- Al-Kubati Waheeb
- Al-Masari Hayder Makki
- Al-Sadery Humood
- Alaa Mohammed
- Alabbas Haytham
- Alafghani Haitham
- Alarabi Rayan
- Alawadhi Abdulbari Mohammed
- Alawady Mohammed
- Alawfi Homoud
- Alazzam Saleh
- Albadry Ali Almahdy Ali
- Albahooth Khalid
- Albalawi Ibrahim Altedlawi
- Albeshri Khalid A.
- Aleksandr Ogoreltsev
- Alfalah Haitham
- Algatanesh Nassib
- Alghamdi Faisal Saleh
- Alghamdi Saleh
- Alghuliga Abdullah
- Alhamdany Arkan Shubber
- Alharbi Abdulhamid
- Alhazmi Barrag
- Alhazmi Waleed
- Alhedaithy Alhanouf
- Alhendawey Moaaz
- Alhussaini Mohammed Khalid
- Alhussien Fade Ahmed
- Ali Ali Sayed
- Ali Bandar Idrees A.
- Ali Doaa
- Ali Mahmoud
- Ali Mohamed Anwar Abdel Razik
- Ali Muhammad Zulfiqar
- Ali Shabeer
- Ali Syed Muhammad
- Aliyu Yakubu
- Aljathlany Yousef
- Aljawhari Adel Ali
- Alkhalegy Ayman
- Alkhayat Ali
- Alkhayat Mohammed Amer
- Allaeys Mathias
- Almaghrabi Alhassan Hesham
- Almasri Mahmoud
- Almulhim Abdulrhman
- Alnabarawi Mahmoud
- Alnahas Yousef
- Alnashar Ahmed
- Alnoqaidan Emad
- Alomieri Adil
- Alotaibi Abdullah
- Alotaibi Abdulrahman
- Alotaibi Abdulrahman
- Alowairdhi Tumadher
- Alqarni Ahmed
- Alqasaby Abdallah
- Alqudaihi Heba
- Alrashidi Yousef
- Alsallum Ofays
- Alsawat Salem
- Alshabi Yaser Ahmad
- Alshehari Mohammed Mohammed Hasan
- Alshukr Sarah
- Alsuwaimel Munir A.
- Althobaiti Majid
- Althumali Abdullah
- Altomare Donato F.
- Alvarez Gallesio José Maria
- Alwan Ahmed
- Alwusaibie Ahmed
- Alyami Mohammad
- Alzahrani Khalid H.
- Alzahrani Saud
- Alzamanan Mahdi
- Alzamel Heythem
- Amal Benzakour
- Amary Mohamed Mokhtar
- Amen Mohamed Mohsen
- Amer Nasser Mohammed
- Amir Mohammed
- Amr Wesam
- Andrea Chierici
- Andrea Police
- Andriola Valeria
- Angrisani Marco
- Angulo Victor Manuel Pinto
- Antonio D’Alessandro
- Anwer Mariyah
- Aoun Rany
- Arbutina Dragana
- Archid Rami
- Aremu Isiaka
- Argenio Giulio
- Arnold Marion
- Arnouse Mohamed Mohamed Hamdy
- Asar Khalid Mohammad Ibrahim
- Ashimov Erkin
- Ashraf Tamer
- Asif Muhammad
- Aslam Mohammad
- Ateeb Mujammad
- Atef Gehad
- Atici Semra Demirli
- Attia Ahmed Mohamed
- Ayoub Larissa
- Azer Mina
- Aziz Mina
- Aziz Muhammad Akram Abdul
- Ba Mamadou
- Bacher Annica
- Bafaraj Ahmed
- Bagaglini Giulia
- Balla Andrea
- Barbary Hesham
- Barberis Andrea
- Barbon Carlotta
- Basendowah Mohammed
- Bashah Moataz M.
- Bashir Umar
- Bashlachev Andrey
- Bassuni Majid
- Bàmbina Fabrizio
- Bellato Vittoria
- Belli Andrea
- Bensaad Ahmed
- Berchtold Valeria
- Bernante Paolo
- Bertels Laurie
- Beshir Hatem
- Bhatt Nikita
- Bogdan Stoica
- Bonci Eduard-Alexandru
- Borasi Andrea
- Botros Ibram
- Botteri Emanuele
- Bouchrika Amal
- Boukorou Garyfallia
- Brahmachari Swagata
- Bruzzaniti Placido
- Calik Bulent
- Calvo Mikel Prieto
- Campagnaro Tommaso
- Campanelli Michela
- Campennì Paola
- Canfora Alfonso
- Capizzi Vita
- Carrano Francesco Maria
- Castaldi Antonio
- Cavallaro Giuseppe
- Chacón Mario Franco
- Charalabopoulos Alexandros
- Cherfa Harieche Abdennour Abderahim
- Chiarella Vito
- Chipaila Jackson
- Cianci Pasquale
- Cillara Nicola
- Cirillo Bruno
- Ciubotaru Cezar
- Colás-Ruiz Enrique
- Colleoni Ramiro
- Colombo Francesco
- Coniglio Denise
- Costanzo Federico
- Cuk Vladica
- Curtis Nathan
- Dagorno Claire
- Daibes Adel Goda Hussein
- Danilov Michail
- Dare Julius Kolajo
- Daudi Irfan
- Davies Justin
- Dawdi Salahaldeen
- De Falco Nadia
- De Fatico GSerena
- De La Hermosa Alicia Ruiz
- De Lucia Francesca
- De Sousa Xavier
- Del Muslim Ka
- Demeester Steve
- Depuydt Martijn
- Dere Ümit Akın
- Derinov Aleksandr
- Di Bartolomeo Alessandro
- Di Carlo Sara
- Di Lorenzo Nicola
- Di Martino Marcello
- Di Saverio Salomone
- Diamantopoulou Angela
- Díaz Andrés Vega
- Díaz Jeancarlos J. Trujillo
- Doerner Johannes
- Dogjani Agron
- Don Cristine
- Duran Erik Efrain Sosa
- Durayb Norah
- Dursun Ayberk
- Dziakova Jana
- Echevarria Miguel Jose Pinto
- Edassy Mohammed El
- Efetov Sergey
- Eke Grace
- El-Hussuna Alaa
- El-Wakeel Ayman
- Elalfy Khaled
- Elbahrawy Aly
- Elbatal Amira Alsayed Abdelhai
- Eldeeb Ahmed
- Eldemery Mohamed
- Eldesouki Mohammed Nabil
- Eldesouky Omnia
- Eleshra Ahmed
- Elfeki Hossam
- Elgaly Maher Elesawi Kamel
- Elgamal Hesham
- Elganash Abdelazim
- Elgazar Amr
- Elgazar Elsayed Aly
- Elgendy Hesham
- Elghadban Hosam
- Elhafez Raheem El-Gohary Abd
- Elhattab Ahmad
- Elhawary Ahmed Adel
- Elkafoury Ahmed
- Elkased Ahmed Farag
- Elkatt Mahmoud Mohamed
- Elkhouly Ahmed G.
- Elmesery Mohamed
- Elmetwally Ashraf S.
- Elmoghazy Mohamed Ibrahim
- Elnaghi Hisham
- Elnakash Ahmed Mostafa
- Elnemr Islam
- Elnour Ahmed Abd Elbaset Elsayed Abu
- Elrefai Mohamad
- Elsaied Adham
- Elsanhoury Kareem
- Elsanosi Abdelrhman Azhari Mohammed
- Elsayed Mohamed Abdelmoneim
- Elsayed Mohamed Ahmed Abdelhalim Ahmed
- Elseberbihy John Rezk Hanna
- Elshaer Ahmed Mohammed
- Elshazli Mostafa
- Elsheik Ahmed
- ElSheikh Ahmed M.
- Elsherbiny Osama
- Elshikh Essam
- Elsorogy Mohamed
- Elvira Tartaglia
- Elzayady Hany M.
- Elzayat Ibrahim
- Elzeftawy Shady Ahmed
- Emile Sameh Hany
- Enad Farazdaq
- Epifani Angelo Gabriele
- Eral Burak
- Ezz Ahmed
- Fadel Bashir A.
- Fahiem Andrew
- Fakhr Ibrahim
- Falaschi Federica
- Familiari Pietro
- Farag Mohamed
- Farid Ahmed Mohammed
- Farid Mohamed
- Farouk Mohamed
- Farouk Nehal
- Fathy Mohammad
- Fatima Tauseef
- Fawzy Ahmed
- Faye Papa Mamadou
- Fayed Mohamed Abdelaziz Mohamed Abdalla M
- Fazli Mohammad Rafi
- Felix Marcos José Serrato
- Ferrara Francesco
- Ferrario Luca
- Ferri Lorenzo
- Fieturi Nura Ahmed
- Fikry Mohamed
- Fiore Antonio
- Flores Manuel SSalas
- Foppa Caterina
- Fouad Amgad
- Franceschilli Marzia
- Fransvea Pietro
- Frasson Matteo
- Frauenfelder Claire
- Frazzetta Giuseppe
- Freitas Carla
- Frigerio Isabella
- Frontali Alice
- Gaarour Osama
- Gabr Mohamed A.
- Gad Hamada
- Galala Ahmed
- Gallo Gaetano
- Gamal Ehab
- Gamal Sameh
- Ganau Mario
- Garino Mauro
- Garmanovs Tatiana
- Garoufalia Zoe
- Garreffa Emanuele
- Gazia Carlo
- Gehwolf Philipp
- Gendy Samuel Elkess Morcos
- George Ihediwa
- Ghabisha Saif Ali
- Ghafoor Tariq
- Ghanem Ahmed
- Gharbia Mohamed
- Ghazala Mohamed Jomma
- Ghonim Mostafa
- Ghunaim Mohammed
- Giani Alessandro
- Giardino Alessandro
- Giarratano Gabriella
- Giuffrida Maria Carmela
- Giugliano Marco
- Golea Smain
- Gomez Caroina Gonzalez
- Gondal Zafar
- Gonzales Erick Ivan Huaman
- Gorin David
- Gots Alexander
- Grappelli Virgilio Michael Ambrosi
- Guaitoli Eleonora
- Guerci Claudio
- Guerrero José Eaazim Flores
- Guida Anna
- Gulcu Baris
- Gurung Binay
- Haddad Feras
- Hadi Sabah Anwar
- Hamdi Salah
- Hamed Esmael Ali
- Hamed Hosam
- Hamed Mohamed Korayem Fattouh
- Hammad Muhammed Alaa Moukhtar
- Hamza Ahmed
- Hanif Muhammad Amir
- Hasani Ariola
- Hassan Mohamed Ali Gad
- Hassan Mohamed Salah Eldin
- Hassan Redan
- Hatm Mohamed
- Haydal Ashraf
- Hegazy Mostafa
- Hejazi Soha
- Helal Mohamed Alaa Abdelmoez
- Helmy Ahmed Hazem I.
- Hemidan Ahmed Gamal Abouelfetouh Ibrahim
- Henes Mohsen Michael
- Hesham Hosai Todd
- Hijazi Bilal Ahmed
- Hilling Denise
- Holubar Stefan D.
- Hussain Marwah
- Hussein Abdinafic Mohamud
- Ibrahim Ahmed
- Ibrahim Hamed
- Ibrahim Yaser
- Ibrahim Yassin
- Ignatov Ivan
- Ilkul Jh.
- Inam Aatif
- Inama Marco
- Ioan Tanase
- Ioannidis Argyrios
- Iossa Angelo
- Ippoliti Simona
- Isaiah Isaac A.
- Isci Sevim
- Islam S. M. Nazmul
- Ismail Ahmed Mahmoud Ahmed
- Izzo Giuliano
- Jain Amita
- Jallad Fadi Sami
- Jaman Ismail
- Jameel Muhammad Khurram
- Japhet Ntezamizero
- Jarboa Lutfi
- Jarvis Bennie L.
- Jasso Manuel Meza
- Javed Ayesha
- Jawad Fassi Fihri Mohamed
- Jeffery James
- Jolayemi Edward
- Jooma Uzair
- Juloski Jovan
- Junaid Sheikh
- Kaldarov Ayrat
- Kandel Mohamed Mosaad
- Karbovnichaya Elena
- Kassem Amr
- Kateb Abdullah
- Kaur Mandeep
- Kaya Tayfun
- Kazachenko Ekaterina
- Kazim Shuiab
- Kerawala Asad Ali
- Kewulere Raji Taofiq
- Khadwardi Faisal
- Khafagy Tamer
- Khafagy Wael
- Khalaf Mohsen George
- Khalil Medhat M. H. A.
- Khan Irfan Jan
- Khan Roaa Ghazi
- Khare Ritu
- Khashshan Sohib Mohammed Mohammed
- Khawar Mahwish
- Khoj Mohammed
- Khokhar Muhammad Imran
- Khudhayr Essa
- Khuller Somyaa
- Kilinc Gizem
- Kırmızı Yasemin
- Kiselev Michail
- Kitsenko Yury
- Klein Mads Falk
- Koc Mehmet Ali
- Koirala Dinesh Prasad
- Kostakis Ioannis D.
- Kress Melissa
- Kropshofer Stephan
- Kumar Sanjeev
- La Torre Filippo
- Laina Juan Luis Blas
- Lakshmi Harish Neelamraju
- Landaluce-Olavarria Aitor
- Lapolla Pierfrancesco
- Larbi Noureddine
- Lateef Nawras Falah
- Lathan Sanaz
- Lawal Bashir
- Lederhuber Hans
- Lelpo Benedettao
- Leo Cosimo Alex
- Leventoğlu Sezai
- Lewis Sophia
- Liakakos Theodore
- Light Alexander
- Lisi Giorgio
- Litta Francesco
- Lotfy Ahmad
- Loukil Issam
- Luc Jessica G. Y.
- Lule Herman
- Lund Jon
- Lutfi Basma Waseem
- Machairas Nikolaos
- Madbouly Khaled
- Madhuri Thumuluru Kavitha
- Maffioli Anna
- Maghrebi Houcine
- Mahadel Osama Abdel Salam
- Majeed Mudassar
- Majid Haroon Javaid
- Makasarwala Murtaza
- Malek Amgad Nashaat Abdel
- Malibary Nadim
- Maliki-Alaoui Mohamed
- Manetti Andrea
- Mangiameli Giuseppe
- Mansour Khaled Yousery Ibrahim
- Marafante Chiara
- Marano Alessandra
- Marcos Alberto
- Mariani Aurora
- Mariani Nicolò Maria
- Mariateresa Grasso
- Marino Marco V.
- Marra Angelo Alessandro
- Marsanic Patrizia
- Martin Linda W.
- Martin-Perez Beatriz
- Martinelli Fabio
- Marzouk Ahmed Msm
- Marzouk Khalid
- Matarangolo Antonio
- Maurizi Angela
- Mazingi Dennis
- Mbatani Nomonde
- Mbiine Ronald
- Mccaul Jeannie
- Mcnamara Deborah
- Medkova Iuliia
- Mehr Asma
- Mehraj Asif
- Mejdane Abdelhadi
- Menna Maria Paola
- Metwally Mohamed
- Mikhael Marolla Maher Eskander
- Mikrish Amir
- Milad Nader
- Milana Flavio
- Milford Karen
- Milic Ljiljana
- Millan Monica
- Mingoli Andrea
- Minoldo Javier
- Mirza Mohammad Amin
- Mitul Ashrarur Rahman
- Moeslein Gabriela
- Mohamed Mohamed Mohamed Adel
- Mohamed Anwar Yahya A.
- Mohamed Omnia Y.
- Mohammad Mohammad Aminu
- Mohammed Khalid Fathelrahman Bakier
- Mohammed Mahfoudh
- Mohammed Mahmoud M.
- Mohammed Mohammed Mustafa Hassan
- Mohammed Ouazni
- Mohmmed Mona Mhmoud
- Molena Daniela
- Montalbán Beatriz Cros
- Monti Alessio
- Montuori Mauro
- Mora-Guzmán Ismael
- More Vinal
- Morini Andrea
- Moustafa Mohammad Montaser Hassan
- Mpaili Eustratia
- Mubarak Ashraf Abdelazeem Mohamed
- Mudawi Ishag M.
- Muhammad Aneeqah Din
- Muresan Mihai-Stefan
- Mussa Haidar Aal
- Musthafa Shameel
- Nabeeh Mohamed Adel
- Nabil Tamer
- Nabwana Ambrose
- Nadeem Munawar
- Nadeem Uqba
- Nageeb Ashraf
- Nageeb Ramy Mikhael
- Najm Ghadah
- Nakazwe Mildred
- Nasef Hazem
- Nasir Muhammad
- Ndong Abdourahmane
- Negida Ahmed
- Negoi Ionut
- Nekhala Islam
- Ng Hwei Jene
- Ng Jen Siang
- Niaz Khurram
- Nimir Nessrein
- Ninkovic Marijana
- Nittala Rigved
- Njau Aidan
- Njokanma Iloba Gabriel
- Njoroge Githu
- Novikova Anastasia
- null null
- Obadiel Yasser Abdurabo
- Obure Ralph Ombati
- Ocklind Miranda E. K.
- Odion Clement
- Okunlola Abiodun Idowu
- Oludara Mobolaji Adewale
- Oluwasuyi Ige
- Oluyomi Ayodele Samuel
- Omar Mohamed I.
- Omar Tilioua
- Oosthuizen Pj
- Orecchia Luca
- Orlando Francesco
- Osman Khalid Abdalla Abdelgadir
- Osman Luqman
- Ouadii Mouaqit
- Oyedepo Charles Olajide
- Paci Marco
- Pagano Gianluca
- Pakula Andrea M.
- Palkhi Yusuf
- Pandey Diwakar
- Papadopoulos Georgios
- Parello Angelo
- Parente Alessandro
- Parida Lalit
- Pata Francesco
- Peediyakkal Saidalavi Padinhare
- Pellino Gianluca
- Perra Teresa
- Petagna Lorenzo
- Pérez-Bertólez Sonia
- Picciariello Arcangelo
- Pignatelli Marcello Filograna
- Pinotti Enrico
- Pio Luca
- Pirovano Riccardo
- Pirozzi Brunella
- Pitoni Ludovica
- Pohl Linda
- Ponholzer Florian
- Popoola Ademola
- Porcu Alberto
- Portela Carlos Antonio Sanchez
- Pouwels Sjaak
- Prodromidou Anastasia
- Puerto Puerto Alejandro
- Puzenko Dmitriy
- Quesada Matias
- Qurashi Kamran
- Qureshi Ahmad Uzair
- Rabea Mohamed
- Rachid Mohamed Ghassane
- Rao Satish
- Raptis Dimitri
- Rashid Arshad
- Rashid Shahid
- Ratto Carlo
- Rayamajhi Shreya
- Raza Muhammad Asif
- Rea Lo Dico
- Regal Samer
- Rho Maurizio
- Rihan Eslam
- Rimonda Roberto
- Rizk Tarek Taher
- Robles Eloy Morasen
- Rodimov Sergey
- Romic Ivan
- Roscio Francesco
- Rottoli Matteo
- Rubio-Perez Ines
- Ruiz Luis Angel Garcia
- Saad Ahmad
- Saadeldin Abdelhalim
- Saber Wael
- Sabet Khaled
- Sacchi Matteo
- Saeed Muhammad Ahmad
- Sahnan Kapil
- Said Khalid Babieker
- Saklani Avanish
- Sakr Ahmad
- Saleh Amr
- Salem Eman Abdalla Mohamed
- Salem Mohamed Abouelmagd
- Salim Mohammed Said Mahmoud
- Salim Omer El Faroug H.
- Salim Sami
- Sallam Ibrahim
- Salman Usama
- Samadov Elgun
- Samaha Mahmoud Yahia
- Sanad Aly
- Sanad Mohammed
- Santos Esther Garcia
- Santurro Letizia
- Sapienza Paolo
- Sarhan Fetoh Alaaeldin Fetoh
- Sarmah Panchali
- Sasia Diego
- Sauri Fozan
- Sayouh Mohammad
- Sbaih Mohammed
- Scafa Anthony Kevin
- Schuldes Alejandro Daniel Lira
- Sciaudone Guido
- Sebelik Merry
- Seiam Moham
- Selvaggi Francesco
- Sembawa Hatem A.
- Semilan Anmar
- Senent-Boza Ana
- Senra Fatima
- Sergeevich Kochetkov Viktor
- Shafique Muhammad Salman
- Shah Rahmat Ullah
- Shah Shahzad Alam
- Shaheen Abelnasser
- Shahein Mostafa
- Shahin Yasser
- Shaikh Abdul Razaque
- Shaker George Samir Habib
- Shalaby Mostafa
- Shams Maher
- Sharaf Hesham
- Sharafeldin Hatem Abdelrahman Ahmed
- Sharma Meenakshi
- Shawer Sami
- Shawer Sherif
- Shehata Mina
- Shemes Ayman
- Sherbiny Kareem El
- Sherif Ahmed Elshawadfy
- Shetiwy Mosab
- Shittu Asimiyu Adekunle
- Shomoye El-Zaki
- Sibiany Abdulrahman
- Siboe Mark M. W.
- Sidorova Lyudmila
- Sileri Pierpaolo
- Silva Jesús
- Simioni Andrea
- Sindy Abdullah
- Singh Baljit
- Siragusa Leandro
- Situ Oladele
- Skandalakis Georgios P.
- Slavchev Mihail
- Sleilati Fadi
- Sobh Mohamed Ramadan
- Sofan Mostafa
- Soggiu Fiammetta
- Sokmen Selman
- Soliman Ahmed
- Spinelli Antonino
- Spolverato Gaya
- Ssenono Kavuma Daniel
- Stanislav Berelavichus
- Stavrou George
- Stijns Jasper
- Styliani Vasileiadou
- Subramanian Sivaraman
- Suliman Omar AAbu
- Tabasi Hani
- Tagg Gamal Hassan El
- Tairab Elsanousi Ibrahim Sabir
- Taki-Eldin Ahmed
- Tallon-Aguilar Luis
- Taman Mohamed
- Tamburrini Alessandro Paolo
- Tamini Nicolò
- Tanda Cinzia
- Tarabay Ahmed
- Tashkandi Wail
- Tashkandi Waleed
- Tecchio Piero
- Tejedoe Patricia
- Tesik Philip
- Testa Valentina
- Thakrar Dixa
- Thein Nyan
- Tohamy Aley Eldin
- Toma Omar
- Tong Kin Seng
- Torky Radwan Abdelsabour
- Towfigh Shirin
- Troci Albert
- Tropeano Francesca Paola
- Tsounaki Efthymia
- Tuncer Korhan
- Turrado-Rodríguez Víctor
- Uccelli Matteo
- Ugarte-Sierra Bakarne
- Uggeri Fabio
- Uraiqat Ahmad
- Uranitsch Stefan
- Uslu Gülberk
- Valente Marina
- Valery Nekoval
- Van Daele Elke
- Van Praet Charles
- Van Ramshor Gabrielle H.
- Vanlander Aude
- Vanommeslaeghe Hanne
- Varma Gopala Pillay
- Vázquez-Melero Alba
- Vella Ivan
- Veltri Marco
- Venturelli Paolina
- Vikrantmr Sharma
- Villwock Jennifer
- Visconti Diego
- Vishwakarma Kushagra
- Vosloo Susan
- W Njoroge P.
- Waleed Aasma
- Wali Zubair
- Waqar Shahzad Hussain
- Warusavitarne Janindra
- Waseem Talat
- Wexner Steven
- Wuraola Funmilola Olanike
- Yacir El Alami
- Yakar Fatih
- Yanaga Katsuhiko
- Yassin Nouf
- Yassine Wassim Abou
- Yeşilyurt Değercan
- Yildiz Alp
- Yousef Yousef Mohamed
- Youssef Mohamed
- Youssef Youssef Abdel Aziz
- Yves Van Nieuwenhove
- Zafar Noman
- Zahra Tarek
- Zaidi Mariam
- Zaieem Mohammad
- Zakaria Hazem M.
- Zakharenko Alexander
- Zancana Giuseppa
- Zentar Aziz
- Zese Monica
- Zewar Karem Shahin Mohamed
- Zidan Ahmed Azmy
- Zigiotto Daniele
- Zubayraeva Albina
- Zuhdy Mohammad
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
- Author
- Aamir Faiqa Binte
- Aamir Syed Roohan
- Ababneh Adnan
- Abbal Muhammad Anas
- Abbas Ahmed M
- Abbas Mostafa
- Abd-Albain Montasir A
- Abdalei Abdulwahab
- Abdalla Ahmed
- Abdalla Ahmed Yassir
- Abdalla Mohamed Galal Ali
- Abdalla Zainab
- Abdallah Mohamed M
- Abdalmahmoud Noon Ezzeldien
- Abdalsadeg Rowa
- Abdelaal Ahmed M
- Abdelbagi Alnazeer Y
- Abdelbaky Mostafa
- Abdelbaset Doaa
- AbdElbaset Esraa
- Abdelbast Menhag
- Abdelfatah Mohammed Abdelnasser
- Abdelgawad Samia
- Abdelhamid Mohamed M
- Abdeljaber Mahmoud
- Abdelkhalig Mubarak
- Abdelmaksoud Mohamed
- Abdelmeguid Rana
- Abdelmelek Dhia Errahmane
- Abdelnaeam Samah
- Abdelnasser Mohammad K
- Abdelrahim Najwa
- Abdelrahman Amira
- Abdelrahman Ayman
- Abdelsalam Hebatalla
- Abdelsamed Enas Abdelbaset
- Abdelwahab Khaled
- Abdoun Meriem
- Abdulali Fatima
- Abdulaziz Mohamed
- Abdulla Dheba Almukhtar
- Abdullah Bahiyah
- Abdullah Bahiyah
- Abdullah Walaa
- Abdullahi Habiba Ibrahim
- Abdulrahman Ahmed
- Abdulrasheed Lubabatu
- Abdulwahed Eman
- Abdulwahed Eman
- Abeysirigunawardana Dewmi
- Abidin Muhammad Fihmi Zainal
- Abiola Olukayode
- Abiyere Henry
- Abodina Ahmed Mohammed
- Aboelela Reham
- AboElfarh Hadeer Elsaeed
- Aboudlal Husein
- AbouHiekal Osama
- Aboulfotouh Ahmed
- Abozid Anwaar
- Abubaker Noora
- Abubaker Noora
- Abufanas Asma
- Abughanima Mahmoud
- Abuhashem Shehab
- Abulafia Daniel
- Abushaala Fatima
- Abushanab Khaled
- AbuShawareb Issa
- Abuuqteish Hamza
- Abuzaho Amany
- Achem Arome
- Adam Eithar
- Adam Mohammed
- Adam Mohammed A
- Addalla Mohamed
- Addley Jordan
- Adeleye Gbadebo
- Adeniyi Adebayo
- Adewole Nathaniel
- Adeyemo Olabisi
- Adeyeye Ademola
- Adeyeye Ademola
- Adly Michael
- Adnan Siti Nasyirah Nisya
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adze Joel Amwe
- Afeikhena Ehis
- Agida Teddy
- Agilla Hamza
- Agnew Emilie
- Agu Joy Onyekachi
- Ahmad Zatul Akmar
- Ahmed Abdalla
- Ahmed Ahmed
- Ahmed Ahmed
- Ahmed Alaaaldeen
- Ahmed Entisar
- Ahmed Habeeba
- Ahmed Hatem
- Ahmed Reem
- Ahmed Rehab
- Ahmed Rihab
- Ahmed Rogia Ahmed Abdalla
- Ahmed Ruaa
- Ahmed Sharwany
- Ahmed Uzair
- Ahmed Wahiba
- Ahmeed Sultan
- Airede Lydia Regina
- Aitchison Lori
- Ajredini Mirac
- Ajulo Adeshina A
- Akaba Godwin
- Akasha Mazin
- Akbar Maha Ghulam
- Akbuz Seyma Orcan
- Akdere Hakan
- Akın Bilge
- Akkaya Ege Nur
- Akpamgbo Chukwunonso Nnamdi
- Akwaisah Ayoub
- Al Hammoud Amr
- Al Rawashdeh Toka
- Al-Baw Mahmoud
- Al-Dahdouh Mosheer
- Al-Haek Safa’
- Al-Hazaimeh Mo'ath
- Al-issawi Dima
- Al-Issawi Subhi
- Al-jammal Maryam
- Al-Juaifari Maytham A
- Al-Mwajeh Tesneem
- Al-Omary Sohaib
- Al-Quossi Mohammed
- Al-Shambaty Yasir Babkir Ali
- Al-Shami Qotadah
- Al-Smirat Heba
- Al-Tahayneh Sief-Addeen
- Al-Touny Aiman
- Al-Touny Shimaa
- Al-zawaydeh Alia
- Alaa Ali
- Alabed Ebtihal
- Alagelli Fatma
- Alagoz Ahmet Can
- Alameen Hind
- Alameen Maram
- Alamlih Laith
- Alaqoubi Retaj
- Alarabi Rehab
- Alariby Fatima
- Alatefi Dawood
- Alathameen Nassar
- Albakosh Bashir Abobaker
- Albanopoulos Konstantinos
- Albarhomy Osama
- Albarki Aisha
- Albashaireh Alaa
- Albatni Safa Sasi
- Albayadi Eslam
- Alboon Mosab
- Alboridy Muneera
- Alboueishi Asraa Ali
- Aldeges Marwan
- Aldreawi Mohammed
- Alflite Asil Omar Saleh
- Alfrijat Tamam
- Alfrjani Tariq
- Algabbasi Salima
- Algatanesh Nassib
- Alhadad Qamrah
- Alhaddad Hoda Salem
- Alhaleem Ayah
- Alhaleeq Saif
- Alharam Abtisam
- Alhashimi Abdulhadi Mohammed Alhadi
- Alhassan Monzer
- Alhudhairy Sara
- Ali Ahmed
- Ali Aml
- Ali Doua
- Ali Eithar M
- Ali Iqra Fatima Munawar
- Ali Maab
- Ali Manal
- Ali Muhammad
- Ali Radwa
- Ali Rawan Alsheikh
- Ali Rzan Ali Hamedelneel
- Ali Shehroz
- Aliosin Oleg
- Aljamal Mohammad
- Aljamal Sarah
- Alkaraja Layth
- Alkaseek Akram
- Alkazali Mustafa
- Alkchr Hayat Ben Hasan Mohamed A A
- Alkhatib Abed Alazeez
- Allam Shereen
- Almahroush Marin
- Almakki Doha Mohammed Ahmed
- Alnajjar Lara
- Alnajjar Majjd
- Alnatsheh Wesam
- Alnour Ammar
- Alomar Rabiaa
- Alomari Yazan
- Alqaarh Aya
- Alragig Zahra
- Alrifae Ghaliya Mohamed H
- Alrosan Risan
- Alsagoff Sharifah Nor Amirah Syed Abdul Latiff
- Alsaid Hamza
- Alsaify Esmat
- Alsaih Sawsan
- Alsari Najah
- Alshareea Entisar
- Alshawadfy Abdelrhman
- Alshawesh Aisha
- Alsheik Ahmad
- Alsori Mohamed
- Alsoudani Ali
- Altabbaa Hashem
- Altahir Mohamed
- Altair Mawadda
- Altaweel Ahmad
- Altughar Bushra
- Alvarez Matias
- Alvarez-Lozada Luis Adrian
- Alvarez-Lozada Luis Adrian
- Alwahaib Anas
- Alwash Mohammed
- Alzarga Ali
- Alzarouq Ebtisam
- Alzarroug Amal
- Alzghoul Bader
- Alzyoud Osama
- Amarasekara Mishka
- Amary Marwa
- Ametov Amet
- Amin Mostafa K
- Aminu Bashiru
- Aminu Muhammad Baffah
- Ammar Ahmed Siddique
- Amro Dana
- Ananthapadmanabhan Shravankrishna
- Anderson Paul
- Andrew Paul Chimezie
- Andriani Adelaide
- Anestiadou Elissavet
- Angelis Fragkiskos
- Angeslis Fragkiskos
- Aqeel Syed Talha Bin
- Aral Canan
- Arebi Jaber
- Arnaoutoglou Eleni
- Arslangilay Mert
- Arvanitaki Alexandra
- Asadyari-Lupo Shadie
- Ashar Nur Ayuni Khirul
- Ashour Amira
- Ashraf Hamza
- Ashur Abir Ben
- Asjad Imran
- Askar Aamal
- Askin Abdullah Emre
- Aslam Muhammad Nadeem
- Aslan Merve
- Aslangilay Mert
- Astal Mohammed
- Asudo Felicia
- Atadag Yildiz Buyukdereli
- Atef Dina
- Athamneh Tayseer
- Athanasiadis Apostolos
- Ather M Hammad
- Atherton Kristy
- Atia Ahmed
- Atici Semra Demirli
- Atilhan Ridvan
- Atim Terkaa
- Atiq Tabish
- Atta Raneem
- Attia Mohamed
- Attiya Omar
- Awad Hasan
- Awadallah Safaa
- Awoyinka Babatunde
- Ayasrah Salem
- Aydin Cemil
- Aydoğdu Erhan Onur
- Ayogu Emeka
- Ayoub Kerillos
- Ayyad Alaa
- Azboy Ibrahim
- Azer Armia
- Azhari Malaz
- Aziz Aliya Begum
- Babalola Olakunle
- Babar Daniyal
- Babekir Enas Mohammedtom Abdulhameed
- Babiker Afra
- Bacariza Loreto
- Baccar Marwen
- Badawy Asmaa
- Badi Hussameddin
- Badr Karim
- Badri Danniel
- Bagazi Doaa
- Bailey Ashley
- Bakare Adewumi
- Bakari Maisaratu A
- Bakeer Hibah Bileid
- Bakeer Mohammed
- Balciscueta Zutoia
- Ballah Shirahn
- Balogh Zsolt
- Baltacı Zeynep Hazal
- Banaga Essam Eldien Abuobaida
- Banerjee Arnab
- Banihani Farah
- Barbara Silvia Jasmine
- Barbaro Antonio
- Bareka Metaxia
- Bariun Yara
- Barka Sharf
- Barker John
- Barker Sally
- Barsoum Fady
- Basam Aya
- Basam Aya
- Bassam Ahmad
- Bassey Asi-oqua
- Bataineh Saad
- Bature Stephen Bodam
- Bayram Cigdem
- Baysallar Duygu
- Baziotis-Kalfas Kristian
- Beatson Nicholas
- Bei Michael
- Bektas Sebnem
- Bell David
- Benamor Oumayma
- Benek Duygu Ece
- Benham Emily
- Benismai Israa
- Bensalem Marya
- Bensalem Serien Hossain
- Benyani Simran Vinod
- Bernabei Massimiliano
- Betts Aisling
- Bezweek Adel
- Bhikha Jainey
- Bindra Randipsingh
- Binnawara Muhannud
- Bird Katie
- Bisgin Tayfun
- Bitsianis Stefanos
- Blake Jessica
- Bland Laura
- Blassey Aneel
- Blundell Jian
- Bobba Sriya
- Bockxmeer John Van
- Bolam Scott Matthew
- Bolton Damien
- Bosi Simone
- Bouaoud Souad
- Bouchenak Kamel
- Boussahel Ikram Fatima Zohra
- Bowman Sarah
- Boyd Theresa
- Boyes Hamish
- Boyley Jessica
- Bozhko Maxim
- Bozkir Haktan Ovul
- Bozkurt Mehmet Abdussamet
- Bresadola Vittorio
- Brewster Dani
- Brooke Kenya
- Brown Georgia
- Brown Matthew
- Buari Taiwo
- Buhavac Milos
- Bunjo Zachary
- Burrows Emalee
- Burruso Luca
- Busaidi Ibrahim S Al
- Bushaala Hassan
- Butterworth Yasmine
- Butyrskii Aleksandr
- Cabalag Carlos
- Cade Richard
- Cakcak Ibrahim Ethem
- Cakir Niyazi
- Calini Giacomo
- Calini Giacomo
- Camkıran Elifsu
- Canavese Anna
- Candan Mert
- Canny Mitch
- Canton Joshua
- Capar Mehmet Ali
- Cardelli Stefano
- Carlos Angela
- Carnuccio Emma
- Carre Xenia
- Casciola Francesca
- Castagnini Francesco
- Catalioto Caterina
- Cepe Hale
- Cerinic Pietro Matucci
- Certel Alperen Taha
- Cetınkaya Zeynep Sahan
- Chakroun Sawssen
- Chambers Jessica
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- Chan Alex
- Chan Ashley
- Chan Juliet
- Chan Justin
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- Chand Namisha
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- Chandler Callum
- Chandra Pooja
- Chang Jared
- Chang Kelvin
- Changati Varun
- Chao Phoebe
- Chau Michelle
- Chau Michelle
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- Chawla Tabish
- Chen Andrew
- Chen Brian
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- Cheung Aiden
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- Chidambaram Seevakan
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- Choi Colin Chan-Min
- Choi Horim
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- Chou Justin
- Chowdhury Nebula
- Chowdhury Sharfuddin
- Chua Alan
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- Clanfield Matthew
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- Das Ankita
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- Dong Jason
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- Edwards Liam
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- Ekwebelam Jennifer
- El-Masry Mariam
- el-mola Amira Gad
- El-Sakka Ahmed
- El-Taher Ahmed Kamal
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- Eldaim Khalid Nour
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- Eldomiaty Donia
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- Elfadli Mustafa
- Elfallah Sara
- Elfeki Hossam
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- Elgharib Asmaa Moatasem
- Elghazy Mohamed Abdelaziz
- Elgherwi Laila
- Elghoul Youssef
- Elgindy Yara
- Elhadi Muhammed
- Elhadi Muhammed
- Elhadi Muhammed
- Elhadi Rawan Elnoman Hamadelniel
- Elhassan Baraa
- Elia Michael
- Elieyioğlu Güşta
- Elizabeth
- Elkenawi Karim
- Elkharaz Omar A
- Elkheshebi Ahlam
- Elkhodary Ahmed
- Ellepola Hasthika
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- Elmaghrabey Abdallah
- Elmehdawi Haitham
- Elmubark Abdelhadi
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- Elporgay Aya
- Elreaid Fadwa
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- Elrishi Fatheia
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- Elsawy Amr
- Eltaib Ibrahim
- Eltayeb Mohammed Omer Mohammed
- Elyan Basel
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- English Tessa
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- fadalah Bader Abo
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- Farrell Michael
- Farrell Michael
- Fasiku Olushola
- Fatima Aleeza
- Fearnley-Fitzgerald Chekodi
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- Wang Zixuan
- Waqar Usama
- Waraich Abdullah
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- Wardeh Salah Abu
- Wasim Tayyiba
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- Watson David
- Wedatalla Mansour
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- Wells Cameron
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- Windsor John
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- Wright Deborah
- Wright Deborah
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- Wu Alan
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- Wu Hongyi
- Wycliff Daniel
- Xiao Haotian
- Xie Maria
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- Xu William
- Xu William
- Xu William
- Yaghmour Jamal
- Yahya Bilal Shuaibu
- Yahya Rawad
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- Yao Sunny
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- Yodkitydomying Chatnapa
- Yong Nathania
- Yoon Si Woo
- You Ha Seong
- Young Simon
- Young Stevie
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- Yousif Fatima Imad
- Yousri Mohamed
- Youssef Ahmed A
- Youssef Arkan
- Yu Hoi Hang
- Yu Victor
- Yuan Grace
- Yue Bosco
- Yue Tiffany
- Yunos Mohamed Haseef Mohamed
- Yusuf Stephen
- Yuzgec Ayse Nilufer
- Zachomitros Fotios
- Zaed Moahmed
- Zafar Fatima
- Zaghloul Ahmed
- Zaheer Adil
- Zaidi Faseeh
- Zain Ahmad
- Zakaria Ahmed
- Zakaria Andee Dzulkarnaen
- Zakaria Mohd Zaim
- Zalloum Jihad
- Zamanbandhon Bushra
- Zambon Mattia
- Zapsalis Konstantinos
- Zargar Kamran
- Zarzour Mohamed A
- Zeng Raymond
- Zeng Raymond
- Zengin Kagan
- Zertuche Juventino Tadeo Guerrero
- Zhang Caitlin
- Zhang Edward
- Zhang Shane
- Zhang Yichi
- Zhao Hailin
- Zheng Helen
- Zhou Karen
- Zhou Yida
- Ziergiebel Felix
- Zou Peishan
- Zuylekom Kate Van
- Zuylekom Katie Van
- Zwain Yasir Adnan
- Zyul'korneeva Sof'ya
- Aladna Abdallah
- Aljoumaa Abdullah
- Nawfal Hamdi
- Niazi Ammar
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Recommended from our members
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
- Alam Manjurul
- 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
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- Alicandro Gianfranco
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- Alikhani Reyhaneh
- Alimohamadi Yousef
- Aliyi Ahmednur Adem
- Aljasir Mohammad A M
- Aljunid Syed Mohamed
- Alla François
- Allebeck Peter
- Almazan Joseph Uy
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- Almidani Omar
- Alomari Mahmoud A
- Alonso Jordi
- Alqahtani Jaber S
- Alqalyoobi Shehabaldin
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- Altaany Zaid
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- Alvis-Guzman Nelson
- Alwafi Hassan
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- Shibuya Kenji
- Shiferaw Desalegn
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- Shin Min-Jeong
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- Shitaye Nebiyu Aniley
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- Shivakumar K M
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- Thayakaran Rasiah
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- Thrift Amanda G
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- Tian Jing
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- Yang Danting
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- Yano Yuichiro
- 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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