Objective To systematically review the incidence, mortality and disease burden of stroke in China. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were electronically searched to collect cohort studies on stroke epidemiology and disease burden from inception to June 30, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 18.0 software. Results A total of 49 studies were included, and the results showed that the overall incidence of stroke in China was 430/100 000 (95%CI 370/100 000 to 490/100 000); The incidence of stroke in men was 510/100 000 (95%CI 450/100 000 to 580/100 000); The incidence of stroke in women was 370/100 000 (95%CI 320/100 000 to 410/100 000). The overall mortality rate of stroke in China was 220/100 000 (95%CI 160/100 000 to 280/100 000); Stroke mortality in men was 160/100 000 (95%CI 120/100 000 to 190/100 000); Stroke mortality in women was 130/100 000 (95%CI 100/100 000 to 160/100 000). The average standard DALY rate of stroke in China was 2 238.09/100 000, and men (3 510.53/100 000) was higher than that of women (2 083.39/100 000). Conclusion The risk of stroke in men in China is significantly higher than that in women, which is mainly attributed to the higher rate of smoking and drinking alcohol, poor eating habits and the neglect of health management. Moreover, interregional differences in aging, especially the higher aging levels in the eastern and northern regions, also have a significant impact on stroke incidence in these regions.
ObjectiveTo investigate the epidemiological and economic burden of acute meningitis and encephalitis syndrome (AMES) in Jinan, so as to provide references for prevention and control of AMES. MethodsThe monitoring data of the AMES Special Reporting System of Jinan City from 2007 to 2014 was collected and the epidemiological characteristics of AMES were analyzed. A questionnaire survey was performed in AMES patients reported in 2013 to collect the basic information, prognosis, medical and non-medical expenses etc. of patients. The DALYs and economic burden of AMES were estimated by using SPSS 13.0 software. ResultsThe average incidence rate of AMES in Jinan was 8.49/100 000 through 2007 to 2014 and the mortality was 4.96‰. The total DALYs were 36 659.51 and the average DALY was 8.27.77.86% were aged less than 14 years old. The average direct economic burden of each case was 19.5 thousand RMB and the average indirect economic burden caused by DALYs was 69.1 thousand RMB. ConclusionThere's heavy burden from AMES, and measures should be made to reduce the incidence and economic burden.
Objective To assess the methodological quality of systematic reviews/ meta-analysis of burden of illness, analyses the factors affecting it, so as to provide a reference basis for improving the methodological quality of related studies. Methods Systematic reviews/ meta-analysis of burden of illness were identified in PubMed, searching from its inception to 12 October 2024. Systematic reviews/ meta-analysis of burden of illness was included, the methodological quality of the included literature was evaluated using AMSTAR-2, and data were extracted using Excel 2021. Results A total of 308 systematic reviews/ meta-analysis were included, with a fluctuating upward trend in the number of publications from 2006 to 2024; of these, a total of 12 were rated as low quality. According to the AMSTAR-2 entries, the largest number of documents fully conformed to entry 16 (82.14%), followed by entry 5 (81.49%), and entry 8 (72.73%); one document conformed to entry 10 (0.32%), and relatively few conformed to entry 12 (68.83%), entry 13 (85.39%), and entry 15 (67.53%). ConclusionThe methodological quality of systematic reviews/ meta-analysis of burden of illness needs to be improved, and the main problems include the lack of pre-study protocols, the absence of a list of excluded literature, and the less than adequate explanation of heterogeneity and risk of bias, etc. There is still a need to further improve the methodological quality of the systematic reviews and to promote the long-term development of evidence based medicine.
ObjectiveTo analyze the burden of digestive diseases attributed to smoking in China from 1990 to 2019 and forecast its change in the next 10 years. MethodsThe Global Burden of Disease database 2019 was used to analyze the burden of digestive diseases attributed to smoking in China from 1990 to 2019. Joinpoint regression model was used to analyze the time variation trend. A time series model was used to predict the burden of digestive diseases attributable to smoking over the next 10 years. ResultsIn 2019, there were 12 900 deaths from digestive diseases attributed to smoking in China, with a DALY of 398 600 years, a crude death rate of 0.91/100 000 and a crude DALY rate of 28.02/100 000. The attributed standardized mortality rate was 0.69 per 100 000, and the standardized DALY rate was 19.79 per 100 000, which was higher than the global level. In 2019, the standardized mortality rate and DALY rate of males were higher than those of females (1.48/ 100 000 vs. 0.11/ 100 000, 38.42/ 100 000 vs. 293/100 000), and the standardized rates of males and females showed a downward trend over time. In 2019, both mortality and DALY rates from digestive diseases attributed to smoking increased with age. ARIMA predicts that over the next 10 years, the burden of disease in the digestive system caused by smoking will decrease significantly. ConclusionFrom 1990 to 2019, the burden of digestive diseases attributed to smoking showed a decreasing trend in China, and the problem of disease burden is more serious in men and the elderly population. A series of effective measures should be taken to reduce the smoking rate in key groups. The burden of digestive diseases caused by smoking will be significantly reduced in the next 10 years.
ObjectiveTo explore the efficacy of community-acquired pneumonia (CAP) by tracheoscopy intervention altimeter and analyze and compare its financial burden.MethodsRetrospective analysis of 419 hospitalized patients with CAP was carried in respiratory medicine department of four hospitals from July 1, 2017 to August 31, 2018 (Changhai Hospital, Shanghai First People’s Hospital, Baoshan Branch of Shanghai First People’s Hospital, and Baoshan Integrated Traditional Chinese and Western Medicine Hospital). According to the time of tracheoscopy intervention treatment, they were divided into 3 groups: 127 patients treated with tracheoscopy intervention during the initial treatment period (within 72 h after obtaining imaging diagnosis) were included in an early intervention group, 158 patients treated with tracheoscopy intervention 72 h after obtaining imaging diagnosis were included in a medium-term intervention group, and 134 patients treated without tracheoscopy intervention were included in a non-intervention group. The total efficiency of treatment, improvement of clinical symptoms, imaging absorption, serum inflammation index level, sputum culture positive rate, change rate, efficiency after drug change, hospital stay and hospitalization cost were compared among three groups.ResultsThe total efficiency of treatment in the early intervention group was higher than that of the medium-term intervention group and the non-intervention group, with statistically significant difference (P<0.05), and the time of normality of body temperature, the time of disappearance of strong sputum and cough in the early intervention group, the absorption time of chest X-rays were shorter than that of the medium-term intervention group and the non-intervention group, and the difference was statistically significant (P<0.05); peripheral blood hemoglobin, serum calcitonin and hypersensitive C reactive protein levels were lower than those in the medium-term intervention group and the non-intervention group, with statistically significant differences (P<0.05), and the sputum-positive and drug-change rates in the early intervention group and the medium-term intervention group were higher than those in the non-intervention group, and the difference was statistically significant (P<0.05); the duration of hospital stay in the early intervention group was shorter than that of the medium-term intervention group and the non-intervention group, and the cost of hospitalization was less than that of the medium-term intervention group and the non-intervention group, and the difference was statistically significant (P<0.05).ConclusionTracheoscopy intervention treatment in the initial period of CAP not only significantly improves the efficacy, but also significantly reduces treatment costs and length of hospitalization, hence it is worth clinical promotion.
Objective The Global Burden of Diseases (GBD) data were used to analyze the trend of the burden of disease of tracheal, bronchial, and lung cancer (TBL Cancer) caused by tobacco in China and globally from 1990 to 2021, and to predict the future development trend. Methods We performed descriptive analysis of the indicators of death and disability-adjusted life years (DALY) in the GBD 2021 database; The Joinpoint regression model was used to calculate the average annual percent change (APCC); The age-period-cohort (APC) model was used to estimate the effect of three independent factors, age, period and cohort, on disease mortality; and the BAPC model was used to project the burden of disease for TBL Cancer from 2022 to 2036. Results From 1990 to 2021, the disease burden of TBL Cancer attributable to tobacco showed an increasing trend in both China and globally, with a much higher burden of disease in men than in women, and a much higher burden of disease attributable to smoking than to secondhand smoke. The APC model showed that the net drift values of mortality in China and globally were ?0.1982% and ?1.5921%, respectively, from 1992 to 2021; the age effect showed that the mortality rate of both China and the world increased with age; the period effect model showed that the mortality rate of China increased and then decreased, and the global mortality rate generally decreased; the cohort model showed that the mortality rate of China and the world increased and then decreased; the BAPC model showed that the mortality rate of China declined slowly in the period of 2022-2036, and the global mortality rate declined even more dramatically. Conclusion The burden of TBL Cancer attributable to tobacco was higher in China than in the world from 1990 to 2021. Tobacco control measures in China have begun to bear fruit in recent years, and we should continue to strengthen our tobacco control initiatives and popularize health knowledge in order to make progress towards the goal of the "Healthy China 2030" plan.
ObjectivesTo estimate the latest burden of disability adjusted life years (DALYs) for liver cancer in China and the long-term trend, and to make future prediction.MethodsBased on the visualization platform of Global Burden of Disease 2016, data on the DALYs for liver cancer in China was extracted. The very recent status in 2016 and the previous trend from 1990 to 2016 were described, using annualized rate of change (ARC). The burden from 2017 to 2050 was further predicted by combining the ARC and the Chinese population data projected by the United Nation.ResultsIn 2016, the total DALYs for liver cancer in China was estimated as 11 539 000 person years (accounting for 54.6% of the global burden), and years of life lost (YLLs) and years lived with disability (YLDs) contributed 98.9% and 1.1%, respectively. The age-standardized DALY rate was 844.1 per 100 000 (3.0 times of the global average) and the male-to-female ratio was 3.4. The DALY rate continuously increased from 1990–2016 (ARC=0.57%), particularly in recent 5 years (ARC=1.75%). Among the DALYs for all cancers, liver cancer contributed approximately 20% and constantly remained as the top 2 (ranking as the number one before year 2005). There were inverse trends in gender, with increasing in males and decreasing in females (ARC was 0.77% and –0.11%, respectively). Hepatitis B infection continually kept the leading cause of DALYs for liver cancer (accounting for nearly 57%), and the DALY rate was gradually increasing (ARC=0.43%). Although the peak age of DALY rate was stable at 65to 69 years, the peak age of the DALYs changed from 55 to 59 years in 1990 to 60 ~ 64 years in 2016. In 2050, the estimated DALYs for liver cancer in China will reach 14.37 million person years, 20.0% more than that in 2017.ConclusionsThe DALYs caused by liver cancer in China exceeds the overall burden of all other countries in the world, and accounts for 1/5 of DALYs for all cancers in local population. The burden in males has been continuously rising, and the leading cause remained unchanged as hepatitis B infection. With population aging, the DALYs for liver cancer in China will be incessant to increase, suggesting the necessity to implement continuous effort in risk factors prevention (e.g. hepatitis B infection), and efficient management in high risk population of liver cancer.
ObjectiveTo analyze the trends and major risk factors of intracerebral hemorrhage (ICH) disease burden by gender in China and globally from 1990 to 2021, and to predict ICH incidence and mortality in China and globally by gender from 2022 to 2046. MethodsBased on the Global Burden of Disease Study 2021 (GBD 2021), data on ICH in China and globally from 1990 to 2021 were collected. Age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (ASDR) were used to assess ICH disease burden and risk factors by gender. Joinpoint regression models were employed to calculate annual percentage change (APC) and average annual percentage change (AAPC) for trend analysis. The Bayesian age-period-cohort (BAPC) model was applied to predict ICH incidence and mortality from 2022 to 2046. ResultsFrom 1990 to 2021, ASIR, ASMR, and ASDR for ICH in China and globally showed declining trends across genders (P<0.05). For males in China and globally, the AAPC for ASIR was ?1.63% (95%CI ?1.69% to ?1.57%) and ?1.14% (95%CI ?1.20% to ?1.07%), respectively. For females in China and globally, the AAPC for ASIR was ?2.27% (95%CI ?2.35% to ?2.18%) and ?1.40% (95%CI ?1.40% to ?1.33%), respectively. The AAPC for ASMR in Chinese and global males was ?1.81% (95%CI ?2.07% to ?1.55%) and ?1.29% (95%CI ?1.43% to ?1.15%), respectively, while for females in China and globally, it was ?2.74% (95%CI ?2.94% to ?2.54%) and ?1.69% (95%CI ?1.82% to ?1.55%), respectively. The AAPC for ASDR in Chinese and global males was ?1.91% (95%CI ?2.11% to ?1.72%) and ?1.39% (95%CI ?1.52% to ?1.26%), respectively, and for females in China and globally, it was ?2.93% (95%CI ?3.07% to ?2.79%) and ?1.85% (95%CI ?1.96% to ?1.74%), respectively. By 2046, the predicted ASIR for ICH in Chinese and global males is projected to be 38.08/100 000 and 44.23/100 000, respectively, and 28.27/100 000 and 29.15/100 000 for Chinese and global females. The ASMR is predicted to reach 37.01/100 000 and 68.57/100 000 for Chinese and global males, and 22.39/100 000 and 29.45/100 000 for Chinese and global females, respectively. ConclusionThe disease burden of ICH in China has demonstrated a declining trend, yet it persistently exceeds global averages and exhibits pronounced gender disparities. There is an urgent need to enhance focus on these gender?specific variations and implement precisely targeted interventions tailored to the distinct risk factor profiles of each gender, in order to achieve further reductions in ICH?related disease burden.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.
ObjectivesTo systematically review the disease burden of osteoporotic fracture (OPF) in China.MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and VIP database for observational studies of the disease burden of osteoporosis in China from inception to Jan 30th, 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies.The descriptive analysis was used to analyze the economic burden of OPF in China.ResultsA total of 23 studies were included. The average cost of OPF was 27 561.27 yuan. Women were more prone to OPF than men. Hip and spinal fractures were the diseases which had higher average hospital costs.ConclusionsWomen are more prone to osteoporotic fractures than men. The higher hospital costs of OPF may cause the reason for growing financial burden of patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify conclusions.