Department of Health and Medical Policy, Daegu City Hall, Daegu, Korea.
Department of Public Health, Graduate School of Kyungpook National University, Daegu, Korea.
J Prev Med Public Health. 2024 Sep;57(5):480-489. doi: 10.3961/jpmph.24.254. Epub 2024 Aug 20.
Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic's impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method.
Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented.
The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with "endocrine, nutritional, and metabolic diseases" and "symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified."
Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.
超额死亡人数是一个将大流行前后的总死亡率进行比较的指标，它提供了大流行影响的全面视图。然而，由于预期死亡人数的估计存在差异，可能会出现差异。本研究旨在使用 3 种方法比较 2019 冠状病毒病大流行期间韩国的超额死亡人数，并使用最合适的方法分析模式。
使用 2015-2019 年作为参考年的死亡率数据来估计 2020 年至 2022 年的预期死亡人数。这种估计采用了 3 种方法：（1）简单平均法，（2）年龄调整平均法，（3）年龄调整线性回归法。还按年龄、性别和死因展示了超额死亡人数。
使用不同的估计方法，超额死亡人数有所不同，使用简单平均法达到最高值，使用年龄调整平均法达到最低值。考虑到人口老龄化和死亡率下降的年龄调整线性回归被认为是最合适的。使用该模型，2020 年的超额死亡人数估计为 0.3%，2021 年为 4.0%，2022 年为 20.7%。整个大流行期间，20 多岁的人超额死亡人数激增，主要归因于自残和自杀人数的增加。此外，结果表明，与“内分泌、营养和代谢疾病”以及“症状、体征和异常临床及实验室发现，不能归类在他处”相关的死亡人数急剧增加。
基于估计方法，超额死亡人数存在显著差异，2022 年增幅明显。年轻人和特定原因的超额死亡人数突显了未来大流行应对措施的关键考虑因素。
