Study on the trend analysis and forecast of the prevalence of three types of unintentional injuries among people under 20 years of age in China, 1990-2021
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摘要:
目的 分析1990―2021年中国3种非故意伤害的发生率、死亡率和伤残调整生命年(disability adjusted life years, DALYs)率情况，并预测2022―2032年疾病负担情况，为制定相应的防控策略提供参考依据。 方法 基于2021年全球疾病负担研究(Global Burden of Disease Study, GBD)数据库，收集1990―2021年中国20岁以下人群跌倒、溺水和火灾、高温和高温物体伤害(fire, heat, hot objects injury, FHHI)3种非故意伤害的发生率、死亡率和DALYs率，利用年估计变化百分比(estimated annual percentage change, EAPC)分析3种非故意伤害的变化趋势，并利用差分自回归移动平均模型(autoregressive integrated moving average model, ARIMA)预测2022―2032年上述3种非故意伤害的发生率、死亡率和DALYs率。 结果 1990―2021年中国20岁以下人群跌倒和FHHI发生率有下降，但变化无统计学意义(EAPC分别为-0.80%、-0.20%, P>0.05)，溺水发生率呈下降趋势(EAPC=-4.30%, P < 0.05)；3种非故意伤害的死亡率和DALYs率均呈下降趋势(死亡率EAPC分别为-3.44%、-5.92%、-7.60%, P < 0.05；DALYs率EAPC分别为-3.15%、-6.01%、-7.32%, P < 0.05)。2021年男性3种非故意伤害的发生率、死亡率和DALYs率均高于女性。15~＜20岁年龄组跌倒和FHHI发生率最高，而10~＜15岁年龄组溺水发生率最高。ARIMA预测结果显示，2022―2032年跌倒和溺水发生率均呈下降趋势，而FHHI发生率将呈上升趋势，预计2032年上述3种非故意伤害的发生率分别为1 968.51/10万、15.87/10万和80.29/10万；预测2022―2032年3种非故意伤害死亡率和DALYs率呈下降趋势，到2032年3种非故意伤害死亡率分别为0.31/10万、-2.18/10万和-0.68/10万；DALYs率分别为68.91/10万、-368.03/10万和-55.68/10万。 结论 2022―2032年我国20岁以下人群FHHI发生率呈上升趋势，其余2种非故意伤害发生率呈下降趋势，3种非故意伤害死亡率和DALYs率也呈下降趋势，提示应加强对青少年儿童防火方面的重视，加强安全教育，保护青少年及儿童的生命健康。 -
关键词:
- 跌倒 /
- 溺水 /
- 火灾、高温和高温物体伤害 /
- 非故意伤害 /
- 差分自回归移动平均模型
Abstract:Objective To analyze the incidence rate, mortality rate, and disability adjusted life years (DALYs) of three types of unintentional injuries falls, drowning, and [fire, heat, and hot objects injury (FHHI)] in China from 1990 to 2021, and to predict the disease burden from 2022 to 2032, providing a reference for formulating corresponding prevention and control strategies. Methods Based on the 2021 Global Burden of Disease (GBD) database, data on the incidence rate, mortality rate, and DALYs rate of falls, drowning, and FHHI in the population under 20 years old in China from 1990 to 2021 were collected. The annual estimated percentage change (EAPC) was used to analyze the trend of these three types of unintentional injuries, and the autoregressive integrated moving average (ARIMA) model was used to predict the incidence rate, mortality rate, and DALYs rate of these injuries from 2022 to 2032. Results From 1990 to 2021, the incidence of falls and FHHI in China′s population under 20 years old showed a downward trend, but the changes were not statistically significant (EAPC=-0.80%, -0.20%, P > 0.05), while the incidence of drowning showed a decreasing trend (EAPC=-4.30%, P < 0.05). The mortality rate and DALYs rate of the three types of injuries showed a downward trend (mortality rate EAPC=-3.44%, -5.92%, -7.60%, P < 0.05; DALYs rate EAPC=-3.15%, -6.01%, -7.32%, P < 0.05). In 2021, the incidence rate, mortality rate, and DALYs rate of these three injuries were higher in males than in females. The highest incidence of falls and FHHI occurred in the 15- < 20 age group, while the highest incidence of drowning was observed in the 10- < 15 age group. ARIMA model predictions showed that from 2022 to 2032, the incidence of falls and drowning will continue to decrease, while the incidence of FHHI would increase. By 2032, the predicted incidence rates of these three injuries would be 1 968.51/100 000, 15.87/100 000, and 80.29/100 000, respectively. The predicted mortality rate and DALYs rate from 2022 to 2032 showed a downward trend for all three types of injuries, with the mortality rates in 2032 predicted to be 0.31/100 000, -2.18/100 000, and-0.68/100 000, and the DALYs rates predicted to be 68.91/100 000, -368.03/100 000, and-55.68/100 000. Conclusions From 2022 to 2032, the incidence of FHHI in China′s population under 20 years old is expected to increase, while the incidence of falls and drowning will decrease. The mortality rate and DALYs rate of all three types of unintentional injuries are also expected to decline. This suggests that greater attention should be paid to fire prevention for adolescents and children, along with strengthening safety education to protect the lives and health of young people and children. -
图 1 1990-2032年中国3种非故意伤害的疾病负担变化趋势预测
图A~C分别是跌倒发生率、死亡率和DALYs率的预测图，D~F分别是溺水发生率、死亡率和DALYS率的预测图，G~1分别是FHHI发生率、死亡率和DALYs率的预测图。ARIMA: 自回归移动平均模型; DALYS，伤残调整生命年; FHHI，火灾、高温和高温物体伤害。
Figure 1. Projected trends in the burden of disease for three types ofunintentional injuries in China, 1990-2032
Figures A-C are the peicted grapls for alincidence, moralin.and DAlys, nespecivelr. figues D-f arethe prdiced geaphs for drowning incidience, morait, .and DAlys, respecively. figures-arethepretictedgeaphs for fre. heat. and hotobiect nuy mcidence, moralty, and DAlys, nespecivelk.ARlMA: aoregesive mnegraled moving average modet, DAlYs: disabilyadjusted lieyear, HH fire, heat hotobjct injuy.
表 1 1990―2021年中国20岁以下人群3种非故意伤害发生、死亡及DALYs情况
Table 1. Incidence of three unintentional injuries, deaths and DALYs among people under 20 years of age in China, 1990-2021
变量
Variable性别
Gender1990年
year2021年
year变化率
Rate of change/%EAPC/% 跌倒 Falls 发生率 Incidence rate/100 000-1 总人群 Total 2 237.41 2 261.10 1.06 -0.80 男 Male 2 707.88 2 574.38 -4.93 -0.07 女 Female 1 728.14 1 901.55 10.03 -1.00 死亡率 Mortality rate/100 000-1 总人群 Total 3.85 1.24 -67.77 -3.44① 男 Male 4.82 1.68 -65.18 -3.15① 女 Female 2.79 0.74 -73.64 -4.11① DALYs率 DALYs rate/100 000-1 总人群 Total 385.75 147.14 -61.86 -3.15① 男 Male 476.02 188.65 -60.37 -2.96① 女 Female 288.03 99.50 -65.46 -3.63① 溺水 Drowning 发生率 Incidence rate/100 000-1 总人群 Total 67.51 21.38 -68.32 -4.30① 男 Male 68.63 24.67 -64.05 -3.82① 女 Female 66.29 17.61 -73.44 -4.98① 死亡率 Mortality rate/100 000-1 总人群 Total 30.58 4.72 -84.58 -5.92① 男 Male 39.21 6.65 -80.03 -5.64① 女 Female 21.23 2.49 -88.26 -6.67① DALYs率 DALYs rate/100 000-1 总人群 Total 2 571.38 381.19 -85.18 -6.01① 男 Male 3 270.33 534.17 -83.67 -5.73① 女 Female 1 814.79 205.61 -88.67 -6.76① FHHI 发生率 Incidence rate/100 000-1 总人群 Total 92.62 77.73 -16.08 -0.20 男 Male 99.35 80.62 -18.85 -0.20 女 Female 85.34 74.41 -12.81 -0.10 死亡率 Mortality rate/100 000-1 总人群 Total 1.99 0.17 -91.37 -7.60① 男 Male 2.07 0.20 -90.28 -7.23① 女 Female 1.90 0.14 -92.77 -8.15① DALYs率 DALYs rate/100 000-1 总人群 Total 182.67 17.70 -90.31 -7.32① 男 Male 189.13 20.10 -89.37 -6.95① 女 Female 175.67 14.94 -91.49 -7.78① 注：DALYs，伤残调整生命年；FHHI，火灾、高温和高温物体伤害；EAPC，年估计变化百分比。
① P < 0.05。
Note: DALYs，disability adjusted life years; FHHI, fire, heat, hot objects injury; EAPC, estimated annual percentage change.
① P < 0.05.
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表 2 1990―2021年中国20岁以下人群不同年龄组3种非故意伤害疾病负担情况
Table 2. Disease burden of three types of unintentional injuries among different age groups under 20 years old in China, 1990-2021
年龄组/岁
Age group/years跌倒 Falls 溺水 Drowning FHHI 发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-1发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-1发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-10~ < 5 1990年 year 1 797.26 9.04 813.10 87.54 68.73 6 029.59 49.01 5.90 520.89 2021年 year 1 197.96 1.86 174.56 17.41 4.83 424.79 30.14 0.32 29.19 变化率 Rate of change/% -33.35 -79.43 -78.53 -80.11 -92.97 -92.95 -38.51 -94.51 -94.40 EAPC/% -1.29① -5.07① -4.97① -5.92① -8.06① -8.06① -1.19① -9.15① -9.06① 5~＜10 1990年 year 2 460.03 2.59 261.18 79.29 28.53 2 367.92 90.45 1.07 97.19 2021年 year 2 262.28 1.07 120.37 22.97 5.16 427.75 65.39 0.16 15.07 变化率 Rate of change/% -8.04 -58.70 -53.91 -71.03 -81.92 -81.94 -27.71 -85.44 -84.50 EAPC% -0.70 -2.66① -2.47① -4.59① -5.54① -5.54① -0.50 -6.20① -6.01① 10~＜15 1990年 year 2 356.33 1.57 197.38 64.86 16.46 1 279.41 109.60 0.43 48.57 2021年 year 2 562.33 0.81 119.39 24.36 4.87 377.62 100.72 0.09 10.93 变化率 Rate of change/% 8.74 -48.28 -39.51 -62.44 -70.42 -70.49 -8.11 -79.39 -77.49 EAPC/% -0.90 -1.88① -1.78① -3.54① -3.73① -3.73① -0.30 -4.97① -4.69① 15~＜20 1990年 year 2 346.61 2.14 263.21 42.25 10.00 729.74 119.19 0.55 62.79 2021年 year 3 017.69 1.31 184.98 20.04 3.85 280.26 116.52 0.13 16.93 变化率 Rate of change/% 28.60 -38.78 -29.72 -52.57 -61.43 -61.59 -2.24 -76.35 -73.04 EAPC/% -0.40 -1.59① -1.49① -2.66① -3.15① -3.25① -0.30 -4.88① -4.30① 注：EAPC，年估计变化百分比；FHHI，火灾、高温和高温物体伤害；DALYs，伤残调整生命年。
① P < 0.05。
Note: EAPC, estimated annual percentage change; FHHI, fire, heat, hot objects injury; DALYs，disability adjusted life years.
① P < 0.05.
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表 3 基于ARIMA预测2022―2032年3种非故意伤害疾病负担情况
Table 3. ARIMA based predictions of the disease burden of three types of unintentional injuries from 2022 to 2032
年份
Year跌倒 Falls 溺水 Drowning FHHI 发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-1拟合度R2
Goodness of fit R2发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-1拟合度R2
Goodness of fit R2发生率
Incidence rate/100 000-1死亡率
Mortality rate/100 000-1DALYs率
rate/100 000-1拟合度R2
Goodness of fit R22022 2 247.22 1.16 141.18 21.18 4.30 341.64 77.71 0.13 14.42 2023 2 121.11 1.07 134.51 20.77 3.81 293.20 76.99 0.08 9.71 2024 2 045.27 0.99 127.50 20.46 3.24 236.53 76.76 0.02 4.49 2025 2 014.25 0.90 120.30 20.24 2.64 172.80 77.23 -0.06 -1.63 2026 2 002.89 0.82 113.03 0.984/ 19.94 2.00 103.28 1.000/ 77.94 -0.14 -8.55 0.940/ 2027 1 997.10 0.73 105.70 0.996/ 19.35 1.33 29.26 0.998/ 78.67 -0.23 -16.02 0.997/ 2028 1 911.93 0.65 98.36 0.997 18.58 0.65 -47.99 0.998 79.28 -0.32 -23.89 0.998 2029 1 986.38 0.57 91.00 17.84 -0.05 -127.30 79.75 -0.41 -31.99 2030 1 980.52 0.48 83.64 17.21 -0.75 -207.64 80.07 -0.50 -40.10 2031 1 974.54 0.40 76.28 16.60 -1.46 -288.13 80.24 -0.59 -48.06 2032 1 968.51 0.31 68.91 15.87 -2.18 -368.03 80.29 -0.68 -55.68 注：ARIMA, 自回归移动平均模型；FHHI，火灾、高温和高温物体伤害；DALYs，伤残调整生命年。
Note: ARIMA, autoregressive integrated moving average model; FHHI, fire, heat, hot objects injury; DALYs，disability adjusted life years.
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