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烧伤的全球宏观经济负担。

The Global Macroeconomic Burden of Burn Injuries.

机构信息

From the Departments of Neurosurgery.

University College London Medical School.

出版信息

Plast Reconstr Surg. 2024 Mar 1;153(3):743-752. doi: 10.1097/PRS.0000000000010595. Epub 2023 Apr 25.

Abstract

BACKGROUND

Standardized estimates of global economic losses from burn injuries are lacking. The primary objective of this study was to determine the global macroeconomic consequences of burn injuries and their geographic distribution.

METHODS

Using the Institute of Health Metrics and Evaluation database (2009 and 2019), mean and 95% uncertainty interval (UI) data on incidence, mortality, and disability-adjusted life-years (DALYs) from injuries caused by fire, heat, and hot substances were collected. Gross domestic product (GDP) data were analyzed together with DALYs to estimate macroeconomic losses globally using a value of lost welfare approach.

RESULTS

There were 9 million global burn cases (95% UI, 6.8 to 11.2 million) and 111,000 deaths from burns (95% UI, 88,000 to 132,000 deaths) in 2019, representing a total of 7.5 million DALYs (95% UI, 5.8 to 9.5 million DALYs). This represented welfare losses of $112 billion (95% UI, $78 to $161 billion), or 0.09% of GDP (95% UI, 0.06% to 0.13%). Welfare losses as a share of GDP were highest in low- and middle-income countries (LMICs) of Oceania (0.24%; 95% UI, 0.09% to 0.42%) and Eastern Europe (0.24%; 95% UI, 0.19% to 0.30%) compared with high-income country regions such as Western Europe (0.06%; 95% UI, 0.04% to 0.09%). Mortality-incidence ratios were highest in LMIC regions, highlighting a lack of treatment access, with southern sub-Saharan Africa reporting a mortality-incidence ratio of 40.1 per 1000 people compared with 1.9 for Australasia.

CONCLUSIONS

Burden of disease and resulting economic losses because of burn injuries are substantial worldwide and are disproportionately higher in LMICs. Possible effective solutions include targeted education, advocacy, and legislation to decrease incidence and investing in existing burn centers to improve treatment access.

摘要

背景

目前缺乏标准化的全球烧伤经济损失估计。本研究的主要目的是确定烧伤造成的全球宏观经济后果及其地理分布。

方法

使用健康计量与评估研究所数据库(2009 年和 2019 年),收集因火灾、高温和热物质导致的伤害的发病率、死亡率和伤残调整生命年(DALY)的平均值和 95%置信区间(UI)数据。使用福利损失价值法,将国内生产总值(GDP)数据与 DALY 一起进行分析,以估算全球宏观经济损失。

结果

2019 年全球有 900 万例烧伤病例(95%UI,680 万至 1120 万例)和 11.1 万例烧伤死亡(95%UI,8.8 万至 13.2 万例),共计 750 万例伤残调整生命年(95%UI,580 万至 950 万例)。这代表了 1120 亿美元(95%UI,780 亿美元至 1610 亿美元)的福利损失,占 GDP 的 0.09%(95%UI,0.06%至 0.13%)。在低收入和中等收入国家(LMICs)中,福利损失占 GDP 的比例最高,大洋洲(0.24%;95%UI,0.09%至 0.42%)和东欧(0.24%;95%UI,0.19%至 0.30%)高于高收入国家地区,如西欧(0.06%;95%UI,0.04%至 0.09%)。在 LMIC 地区,死亡率与发病率的比值最高,这突出表明治疗机会不足,南部撒哈拉以南非洲地区的死亡率与发病率比值为每 1000 人 40.1,而澳大拉西亚为 1.9。

结论

全世界因烧伤造成的疾病负担和由此产生的经济损失相当大,在低收入和中等收入国家(LMICs)中不成比例地更高。可能的有效解决办法包括有针对性的教育、宣传和立法以降低发病率,以及投资于现有的烧伤中心以改善治疗机会。

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