Swedish Civil Contingencies Agency, Karlstad, Sweden.
Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Sweden.
Eur J Public Health. 2018 Oct 1;28(5):853-858. doi: 10.1093/eurpub/cky083.
Worldwide, about 5.8 million people die each year due to injuries. In Sweden, the corresponding number amounts to 3000. There are large differences among injury types regarding the age-profile of the fatalities and as most of them occur in older age groups, counting the absolute number of injury fatalities does not fully reflect the size of the burden of injury.
Using age- and sex-specific life expectancy tables in combination with data on external causes of injury, the number of injury fatalities in Sweden for the time period 1972-2014 is converted to a sum of potential years of life lost (PYLL). We then fit cause and group-specific spline regression models to the data to estimate temporal trends in both fatality counts and PYLL.
There has been a steady reduction in the number of injury fatalities and in the sum of PYLL from the early 1970s to around the year 2000. Since then, there has been an increase in the number of injury fatalities and in the sum of PYLL. The upward trend is mainly explained by an increasing number of deaths due to poisonings and suicide, specifically among younger men.
The increases in suicide and poisoning mortality offset the reductions in downward trending causes of injury mortality during the last decades. The share of PYLL is larger than the share of fatalities for both suicides and poisonings implying that an aging population does not cause the increase.
全球每年约有 580 万人因伤害而死亡。在瑞典,这一数字达到 3000 人。不同类型的伤害在死亡年龄分布上存在很大差异,由于大多数伤害发生在老年人群中,因此仅统计伤害致死的绝对数量并不能完全反映伤害负担的大小。
使用年龄和性别特定的预期寿命表,并结合伤害的外部原因数据,将瑞典 1972-2014 年期间的伤害致死人数转换为潜在寿命损失年数(PYLL)。然后,我们拟合病因和组别特定的样条回归模型来估计死亡率和 PYLL 的时间趋势。
自 20 世纪 70 年代初以来,伤害致死人数和 PYLL 总数呈稳步下降趋势。自那时以来,伤害致死人数和 PYLL 总数都有所增加。这一上升趋势主要归因于自杀和中毒死亡人数的增加,特别是年轻男性。
自杀和中毒死亡率的上升抵消了过去几十年中呈下降趋势的伤害致死原因的减少。PYLL 所占比例大于自杀和中毒的死亡比例,这表明人口老龄化不是导致这一趋势的原因。