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1990 - 2013年英国医疗不良事件的发病率和死亡率:水平、趋势、模式及比较

Incidence and mortality from adverse effects of medical treatment in the UK, 1990-2013: levels, trends, patterns and comparisons.

作者信息

Lunevicius Raimundas, Haagsma Juanita A

机构信息

General Surgery Department, Aintree University Hospital NHS Foundation Trust, Lower Lane, Liverpool, UK.

University of Liverpool, School of Medicine, Liverpool, UK.

出版信息

Int J Qual Health Care. 2018 Aug 1;30(7):558-564. doi: 10.1093/intqhc/mzy068.

Abstract

OBJECTIVE

To present an update on incidence and mortality from adverse effects (AEs) of medical treatment in the UK, its four countries and nine English regions between 1990 and 2013.

DESIGN

Descriptive epidemiological study on AEs of medical treatment. AEs are shown as a single cause-of-injury category from the Global Burden of Disease (GBD) 2013 study.

DATA SOURCES

The GBD 2013 interactive data visualisation tools 'Epi Visualisation' and 'GBD Compare'.

OUTCOME MEASURES

The means of incidence and mortality rates with 95% uncertainty intervals (UIs). The estimates are age-standardised.

RESULTS

Incidence rate was 175 and 176 cases per 100 000 men, 173 and 174 cases per 100 000 women in 1990 and 2013, in the UK (UI 170-180). The mortality from AEs declined from 1.33 deaths (UI 0.99-1.5) to 0.92 deaths (UI 0.75-1.2) per 100 000 individuals in the UK between 1990 and 2013 (30.8% change). Although mortality trends were descending in every region of the UK, they varied by geography and gender. Mortality rates in Scotland, North East England and West Midlands were highest. Mortality rates in South England and Northern Ireland were lowest. In 2013, age-specific mortality rates were higher in males in all 20 age groups compared with females.

CONCLUSIONS

Despite gains in reducing mortality from AEs of medical treatment in the UK between 1990 and 2013, the incidence of AEs remained the same. The results of this analysis suggest revising healthcare policies and programmes aimed to reduce incidence of AEs in the UK.

摘要

目的

呈现1990年至2013年期间英国及其四个国家和九个英格兰地区医疗不良事件(AE)的发病率和死亡率的最新情况。

设计

关于医疗不良事件的描述性流行病学研究。不良事件作为2013年全球疾病负担(GBD)研究中的单一伤害原因类别呈现。

数据来源

2013年全球疾病负担交互式数据可视化工具“Epi可视化”和“GBD比较”。

观察指标

发病率和死亡率的均值以及95%不确定区间(UI)。估计值进行了年龄标准化。

结果

1990年和2013年,英国每10万名男性的发病率分别为175例和176例,每10万名女性的发病率分别为173例和174例(不确定区间为UI 170 - 180)。1990年至2013年期间,英国每10万人中因不良事件导致的死亡率从1.33例死亡(UI 0.99 - 1.5)降至0.92例死亡(UI 0.75 - 1.2)(变化30.8%)。尽管英国每个地区的死亡率趋势都在下降,但因地理区域和性别而异。苏格兰、英格兰东北部和西米德兰兹地区的死亡率最高。英格兰南部和北爱尔兰的死亡率最低。2013年,在所有20个年龄组中,男性的年龄别死亡率均高于女性。

结论

尽管1990年至2013年期间英国在降低医疗不良事件死亡率方面取得了进展,但不良事件的发病率保持不变。该分析结果表明,应修订旨在降低英国不良事件发病率的医疗保健政策和计划。

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