Razzak Junaid, Usmani Mohammad Farooq, Bhutta Zulfiqar A
Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
BMJ Glob Health. 2019 Mar 30;4(2):e000733. doi: 10.1136/bmjgh-2018-000733. eCollection 2019.
There are currently no metrics for measuring population-level burden of emergency medical diseases (EMDs). This study presents an analysis of the burden of EMDs using two metrics: the emergency disease mortality rate (EDMR) and the emergency disease burden (EDB) per 1000 population at the national, regional and global levels.
We used the 1990 and 2015 Global Burden of Disease Study for morbidity and mortality data on 249 medical conditions in 195 countries. Thirty-one diseases were classified as 'emergency medical diseases' based on earlier published work. We developed two indicators, one focused on mortality (EDMR) and the other on burden (EDB). We compared the EDMR and EDB across countries, regions and income groups and compared these metrics from 1990 to 2015.
In 2015, globally, there were 28.3 million deaths due to EMDs. EMDs contributed to 50.7% of mortality and 41.5% of all burden of diseases. The EDB in low-income countries is 4.4 times that of high-income countries. The EDB in the African region is 273 disability-adjusted life years (DALYs) per 1000 compared with 100 DALYs per 1000 in the European region. There has been a 6% increase in overall mortality due to EMDs from 1990 to 2015. Globally, injuries (22%), ischaemic heart disease (17%), lower respiratory infections (11%) and haemorrhagic strokes (7%) made up about 60% of EMDs in 2015.
Globally, EMDs contributed to more than half of all years of life lost. There is a significant disparity between the EDMR and EDB between regions and socioeconomic groups at the global level.
目前尚无衡量急诊医学疾病（EMD）人群负担的指标。本研究使用两种指标对EMD负担进行分析：急诊疾病死亡率（EDMR）和每千人口的急诊疾病负担（EDB），并在国家、区域和全球层面进行分析。
我们利用1990年和2015年全球疾病负担研究中195个国家249种疾病的发病率和死亡率数据。根据先前发表的研究，将31种疾病归类为“急诊医学疾病”。我们制定了两个指标，一个侧重于死亡率（EDMR），另一个侧重于负担（EDB）。我们比较了不同国家、区域和收入组的EDMR和EDB，并比较了1990年至2015年期间的这些指标。
2015年，全球范围内，因EMD导致2830万人死亡。EMD导致的死亡占总死亡人数的50.7%，占所有疾病负担的41.5%。低收入国家的EDB是高收入国家的4.4倍。非洲区域的EDB为每千人273个伤残调整生命年（DALY），而欧洲区域为每千人100个DALY。1990年至2015年，因EMD导致的总体死亡率上升了6%。2015年，全球范围内，伤害（22%）、缺血性心脏病（17%）、下呼吸道感染（11%）和出血性中风（7%）约占EMD的60%。
在全球范围内，EMD导致的生命损失年数占比超过一半。全球各区域和社会经济群体之间的EDMR和EDB存在显著差异。
