Devleesschauwer Brecht, Scohy Aline, De Pauw Robby, Gorasso Vanessa, Kongs Anne, Neirynck Elias, Verduyckt Peter, Wyper Grant M A, Van den Borre Laura
Service Health Information, Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, Brussels, 1050, Belgium.
Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium.
Arch Public Health. 2023 Aug 25;81(1):160. doi: 10.1186/s13690-023-01163-7.
Information on years of life lost (YLL) due to premature mortality is instrumental to assess the fatal impact of disease and necessary for the calculation of Belgian disability-adjusted life years (DALYs). This study presents a novel method to reallocate causes of death data.
Causes of death data are provided by Statistics Belgium (Statbel). First, the specific ICD-10 codes that define the underlying cause of death are mapped to the GBD cause list. Second, ill-defined deaths (IDDs) are redistributed to specific ICD-10 codes. A four-step probabilistic redistribution was developed to fit the Belgian context: redistribution using predefined ICD codes, redistribution using multiple causes of death data, internal redistribution, and redistribution to all causes. Finally, we used the GBD 2019 reference life table to calculate Standard Expected Years of Life Lost (SEYLL).
In Belgium, between 2004 and 2019, IDDs increased from 31 to 34% of all deaths. The majority was redistributed using predefined ICD codes (14-15%), followed by the redistribution using multiple causes of death data (10-12%). The total number of SEYLL decreased from 1.83 to 1.73 million per year. In 2019, the top cause of SEYLL was lung cancer with a share of 8.5%, followed by ischemic heart disease (8.1%) and Alzheimer's disease and other dementias (5.7%). All results are available in an online tool https://burden.sciensano.be/shiny/mortality2019/ .
The redistribution process assigned a specific cause of death to all deaths in Belgium, making it possible to investigate the full mortality burden for the first time. A large number of estimates were produced to estimate SEYLL by age, sex, and region for a large number of causes of death and every year between 2004 and 2019. These estimates are important stepping stones for future investigations on Disability-Adjusted Life Years (DALYs) in Belgium.
因过早死亡导致的生命年损失（YLL）信息有助于评估疾病的致命影响，也是计算比利时伤残调整生命年（DALY）所必需的。本研究提出了一种重新分配死亡原因数据的新方法。
死亡原因数据由比利时统计局（Statbel）提供。首先，将定义根本死因的特定国际疾病分类第十版（ICD - 10）编码映射到全球疾病负担（GBD）病因列表。其次，不明死因（IDD）被重新分配到特定的ICD - 10编码。开发了一个四步概率重新分配方法以适应比利时的情况：使用预定义ICD编码进行重新分配、使用多种死因数据进行重新分配、内部重新分配以及向所有病因重新分配。最后，我们使用GBD 2019参考生命表来计算标准预期生命年损失（SEYLL）。
在比利时，2004年至2019年间，不明死因在所有死亡中所占比例从31%增至34%。大部分不明死因通过预定义ICD编码进行重新分配（14 - 15%），其次是使用多种死因数据进行重新分配（10 - 12%）。每年的标准预期生命年损失总数从183万降至173万。2019年，标准预期生命年损失的首要原因是肺癌，占比8.5%，其次是缺血性心脏病（8.1%）以及阿尔茨海默病和其他痴呆症（5.7%）。所有结果可在在线工具https://burden.sciensano.be/shiny/mortality2019/获取。
重新分配过程为比利时的所有死亡确定了特定的死亡原因，首次使得全面调查死亡负担成为可能。针对2004年至2019年期间的大量死因以及每年的数据，按年龄、性别和地区估算标准预期生命年损失得出了大量估计值。这些估计值是比利时未来伤残调整生命年（DALY）调查的重要基石。
