Wengler Annelene, Rommel Alexander, Plaß Dietrich, Gruhl Heike, Leddin Janko, Ziese Thomas, Lippe Elena von der
Department 2, Epidemiology and Health Monitoring, Robert Koch Institute, Berlin; Department II 1 Environmental Hygiene, German Environment Agency, Berlin.
Dtsch Arztebl Int. 2021 Mar 5;118(9):137-144. doi: 10.3238/arztebl.m2021.0148.
Knowing which diseases and causes of death account for most of the years of life lost (YLL) can help to better target appropriate prevention and intervention measures. The YLL in Germany for specific causes of death were estimated as part of the BURDEN 2020 project at the Robert Koch Institute.
Data from cause-of-death statistics were used for the analysis. ICD codes were grouped into causes of death categories at different levels of disaggregation. The YLL were estimated by combining each cause of death with the remaining life expectancy at the age of death. Deaths and YLL were compared by sex, age category, and regional distribution.
Approximately 11.6 million years were estimated to be lost in Germany in 2017, of which 42.8% were lost by women and 57.2% by men. The largest number of YLL were due to (malignant) neoplasms (35.2%), followed by cardiovascular diseases (27.6%), gastrointestinal diseases (5.8%), and neurological diseases (5.7%). Deaths at younger ages had a greater impact on population health if expressed in YLL: the death share of persons under age 65 was 14.7%, but the years of life lost in this age group amounted to 38.3% of all YLL. The most common causes of death in this group include accidents, self-injury and violence, malignant neoplasms, and alcohol-related diseases.
A large proportion of YLL is borne by young and middle-aged persons. These findings emphasize the need to introduce preventive strategies early in life to reduce the YLL at younger ages, as well as to prevent risk factors for diseases in older ages.
了解哪些疾病和死亡原因导致了大部分生命年损失（YLL）有助于更好地确定适当的预防和干预措施。作为罗伯特·科赫研究所2020年疾病负担项目的一部分，对德国特定死亡原因的生命年损失进行了估计。
分析使用了死因统计数据。国际疾病分类（ICD）编码被分组到不同分解层次的死亡原因类别中。通过将每种死亡原因与死亡时的剩余预期寿命相结合来估计生命年损失。按性别、年龄类别和地区分布对死亡人数和生命年损失进行了比较。
估计2017年德国损失了约1160万年，其中女性损失了42.8%，男性损失了57.2%。生命年损失最多的原因是（恶性）肿瘤（35.2%），其次是心血管疾病（27.6%）、胃肠道疾病（5.8%）和神经系统疾病（5.7%）。如果用生命年损失来表示，年轻时的死亡对人群健康影响更大：65岁以下人群的死亡比例为14.7%，但该年龄组的生命年损失占所有生命年损失的38.3%。该年龄组最常见的死亡原因包括事故、自残和暴力、恶性肿瘤以及与酒精相关的疾病。
很大一部分生命年损失由年轻人和中年人承担。这些发现强调了在生命早期引入预防策略以减少年轻时的生命年损失以及预防老年人疾病风险因素的必要性。
