Annual Percentage Research Articles

Global and Regional Burden of Ischemic Stroke Disease from 1990 to 2021: An Age-Period-Cohort Analysis.

Ischemic stroke is a significant global public health issue that impacts health burdens across various regions. This study analyzed data from the Global Burden of Disease Study 2021 to assess the incidence, mortality, and disability-adjusted life years (DALYs) associated with ischemic stroke worldwide and across different Socio-demographic Index (SDI) regions. Using joinpoint regression and age-period-cohort (APC) models, we examined trends in disease burden and made projections for 2022 to 2035. As of 2021, approximately 7,804,449 (95% UI, 6,719,760-8,943,692) individuals were affected by ischemic stroke, resulting in 3,591,499 (95% UI, 3,213,281-3,888,327) deaths and 70,357,912 (95% UI, 64,329,576-76,007,063) DALYs. These numbers represent increases of 88.0%, 55.0%, and 52.4% since 1990. Despite these increases, age-standardized incidence, mortality, and DALYs rates are declining, with annual percentage change rates (AAPC) of - 0.578%, - 0.927%, and - 14.372%, consistent across all SDI regions. The global rates of IS are influenced by age, period, and cohort, showing increased rates with age but declining over time, particularly in high SDI regions. Major risk factors include hypertension, environmental pollution, and low-density lipoprotein cholesterol (LDL-C). Projections indicate that by 2035, incidence, mortality, and DALYs will rise among those aged 45 and above, while decreasing for those under 35. This highlights the urgent need for preventive and therapeutic strategies targeting ischemic stroke, particularly for individuals over 45, while addressing the impact of major risk factors in high-burden regions.

Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study

BackgroundBreast cancer survivors face a higher risk of cardiovascular disease (CVD) compared to non-breast cancer patients, yet contemporary data on CVD-related mortality within this group remains scarce.ObjectiveTo investigate trends and disparities in CVD mortality among breast cancer patients.MethodsWe queried the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC Wonder) and conducted serial cross-sectional analyses on national death certificate data for CVD mortality in breast cancer patients aged 25 and above from 1999 to 2020. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and analyzed trends over time using the Joinpoint Regression Program, with further analyses stratified by age, race, census region, and urbanization level.ResultsA total of 74,733 CVDs with comorbid breast cancer in the United States were identified between 1999 and 2020. The AAMR from CVDs with comorbid breast cancer decreased from 2.57 (95% CI [2.50–2.65]) in 1999 to 1.20 (95% CI [1.15–1.24]) in 2020, with an average annual percent change (AAPC) of − 4.3. The three most common causes of CVDs were ischemic heart disease (47.8%), cerebrovascular disease (17.1%), and hypertensive disease (10.6%). Our analysis revealed a significant decrease in AAMR for all CVD subtypes, except for hypertensive diseases and arrhythmias. The decrease in annual percent change (APC) was more pronounced in individuals aged ≥ 65 years compared to those < 65 years (-4.4, 95%CI [-4.9, -3.9] vs. -2.9, 95%CI [-4.1, -1.7], respectively. Notably, non-Hispanic Blacks consistently exhibited the highest AAMR (1.95, 95%CI [1.90–1.99]), whereas Hispanic or Latina patients had the lowest AAMR (0.75, 95% CI [0.72–0.78]). The AAMR was also higher in rural regions than in urban areas (1.64, 95%CI [1.62–1.67] vs. 1.55, 95%CI [1.53–1.56]).ConclusionThe study highlights a significant decline in CVD mortality among breast cancer patients over two decades, with persistent disparities by race and region. Exceptionally, hypertensive diseases and arrhythmias did not follow this declining trend.

Rising mortality rates linked to type-2 diabetes and obesity in the United States: An observational analysis from 1999 to 2022.

The prevalence of type 2 diabetes (T2D) and obesity are increasing in the United States. However, population-level data for mortality trends due to T2D and obesity are limited. This study aims to assess these death trends among adults in the United States categorized by sex, race, and geographical location. We queried the CDC-WONDER database for multiple cause of death data of adults aged ≥25 years. The crude mortality rates (CMR), age-adjusted mortality rates (AAMRs), annual percent change (APC), and the average APC (AAPC) along with a 95% confidence interval (CI) were analyzed. From 1999 to 2022, a total of 88,597 T2DM and obesity-related deaths were recorded in the United States. The AAMR consistently increased from 1999 to 2017 (APC: 7.64; 95% CI: 1.91-9.96), followed by a marked rise from 2017 to 2022 (APC: 20.13; 95% CI: 12.88-38.57). The AAMR was approximately 3.58 times higher during the COVID-19 pandemic compared to the period from 1999 to 2019. The AAMR for males was consistently greater than that for females. The highest AAMR was observed in non-Hispanic (NH) Blacks or African Americans, followed by NH White, Hispanic or Latino, and other NH populations. Rural areas (AAMR: 1.86, 95% CI: 1.83-1.89) exhibited a greater AAMR than urban regions 1.26 (95% CI: 1.25-1.27). Our results indicate a substantial increasing trend of T2D and obesity-related deaths in the United States especially during the COVID-19 pandemic.

Temporal and spatial trends in gastric cancer burden in the USA from 1990 to 2021: findings from the global burden of disease study 2021

BackgroundGastric cancer (GC) is a significant public health concern in the USA, and its burden is on the rise.MethodsThis study utilized the latest data from the Global Burden of Disease (GBD) study. We provided descriptive statistics on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of GC across the USA and states. By calculating percentage changes and average annual percentage changes (AAPC), along with conducting age-period-cohort analysis, we assessed the trends in the burden of GC. Decomposition analysis was then performed, followed by the application of an autoregressive integrated moving average (ARIMA) model to forecast changes in ASRs through 2036.ResultsFrom 1990 to 2021, the number of incidence and prevalence of GC in the USA increased, but age-standardized incidence rates (ASIR) trended downward (AAPC = -0.73, 95% confidence interval [CI]: -0.77 to -0.68) and age-standardized prevalence rates (ASPR) (AAPC = -0.99, 95% CI: -1.08 to -0.9) showed a decreasing trend. In addition, the number of deaths, DALYs, age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) in GC showed a decreasing trend. The burden of GC was significantly higher in males compared to females. In addition, we found that the highest incidence and prevalence in females was in the age group of 75-79 years, whereas the highest incidence and prevalence in males was in the age group of 70-74 years.ConclusionGC is a major public health issue in the USA. Although ASIR, ASPR, ASMR, and ASDR for GC are decreasing, the number of incidence and prevalence of GC in the USA remains high, and the disease burden of GC in the USA remains high. Strengthening preventive interventions, particularly for men and patients over the age of 60, will be crucial in the future.

How low can you go? Antibiotic use in Swedish dogs with gastroenteritis

BackgroundCanine gastroenteritis (CGE) is a common cause for seeking veterinary care in companion animal medicine and an area where antibiotics have been reported to be widely used. Therefore, creating relevant benchmarks for antibiotic use in CGE is important when implementing and analyzing antibiotic stewardship interventions. The aim of this paper was to describe the level and temporal trend of systemic antibiotic use for CGE in Sweden between 2020 and 2023.Materials and methodsThis was an observational multicenter cohort study. Retrospective data from 93,641 CGE consultations was extracted from the electronic health record and analyzed. All CGE consultations were included irrespective of age, breed, severity of disease and level of care. To evaluate the data, 100 medical records of CGE consultations were also manually reviewed using a predefined study protocol.ResultsThe overall level of systemic antibiotic use in Swedish dogs diagnosed with gastroenteritis was 5.7% during the study period, with aminopenicillins being the most abundantly used antibiotics (60.2%). The yearly level of antibiotic use in CGE declined from 8.1% in 2020 to 3.9% in 2023, with a statistically significant annual percentage change (APC) of −21.3% (95% CI, −22.8 to −19.7). Concurrently, the annual all-cause mortality decreased for all CGE consultations. Higher levels of antibiotic use were seen in hospitalized CGE (21.7% compared to 2.1% for non-hospitalized CGE, OR 13.1, 95% CI: 12.3–14.0, p &amp;lt; 0.001) and hemorrhagic diarrhetic CGE (21.0% compared to 5.5% for non-hemorrhagic diarrhetic CGE, OR 4.6, 95% CI: 4.2–4.9, p &amp;lt; 0.001).ConclusionThis study revealed a low level and a significantly declining trend of antibiotic use in canine gastroenteritis in Sweden, implicating a high level of awareness and compliance to antibiotic guidelines among Swedish veterinarians. During the same period, the all-cause mortality rates decreased significantly for all CGE consultations, implicating that this level of antibiotic use do not compromise patient safety. Benefiting from automatic surveillance, we hereby provide important benchmarks which should encourage more prudent use of antibiotics in CGE internationally.

Global burden of low vision and blindness due to age-related macular degeneration from 1990 to 2021 and projections for 2050

BackgroundAge-related macular degeneration (AMD) is a leading cause of blindness and low vision worldwide. This study examines the global burden and trends in AMD-related low vision and blindness from 1990 to 2021, with projections through 2050.MethodsData were obtained from the 2021 Global Burden of Disease (GBD 2021) study, covering 204 countries and regions. Key metrics, including the prevalent case numbers, annual disability-adjusted life years (DALYs), age-standardized prevalence rates (ASPR), and age-standardized DALY rates (ASDALYR), specific to low vision and blindness due to AMD, were calculated per 100,000 population. Trend analysis used the estimated annual percentage change (EAPC) method, and K-means clustering identified regions with similar burdens and trends. Autoregressive Integrated Moving Average(ARIMA) and Exponential Smoothing(ES) models provided future projections.ResultsGlobally, the total number of prevalent cases and DALYs has substantially increased. The number of prevalent cases of low vision and blindness due to AMD increased from 3,640,180 (95% UI: 3,037,098 − 4,353,902) in 1990 to 8,057,521 (95% UI: 6,705,284-9,823,238) in 2021. DALYs increased from 302,902 (95% UI: 206,475 − 421,952) in 1990 to 578,020 (95% UI: 401,241–797,570) in 2021. From 1990 to 2021, both the ASPR and ASDALYR for AMD-related low vision and blindness showed a downward trend. The ASPR was 94 (95% UI: 78.32-114.42) per 100,000 population, with an EAPC of -0.26 (95% CI: -0.31 to -0.22), and the ASDALYR was 6.78 (95% UI: 4.7–9.32) per 100,000 population, with an EAPC of -0.94 (95% CI: -1.01 to -0.88). The disease burden of AMD-related low vision and blindness increases with age, and the burden for female patients is slightly higher than for males. Regional stratification by the Socio-Demographic Index (SDI) shows that the burden of AMD-related low vision and blindness in areas with low SDI is higher than in areas with high SDI. From 1990 to 2021, notable increases in ASPR and ASDALYR were observed mainly in the southern and central regions of sub-Saharan Africa. Moreover, the increases in prevalence and DALYs vary by region, country, and level of socioeconomic development. The ARIMA model predicts that by 2050, the number of prevalent cases of low vision and blindness due to AMD will reach 13,880,610(95% CI: 9,805,575–17,955,645), and the DALYs will be 764,731(95% CI: 683,535–845,926). The ES model predicts that by 2050, the number of prevalent cases of AMD-related low vision and blindness will reach 9,323,124(95% CI: 5,222,474–13,423,774), and the DALYs will be 641,451 (95% CI: 383,588–899,318).ConclusionThis study indicates that between 1990 and 2021, the global prevalent cases and DALYs caused by AMD-related low vision and blindness have increased over the past three decades, correlating with factors such as age, gender, socioeconomic status, and geographical location. Predictive models indicate that as the population ages, the number of patients with low vision and blindness due to AMD, along with associated DALYs, will continue to rise. By 2050, it is expected that over 9 million people worldwide will be affected by AMD-related vision loss, with women being particularly impacted. These findings can provide data support for public health planning, resource allocation, and the formulation of medical policies, ensuring an effective response to the challenges posed by the future increase in AMD-related low vision and blindness.

Incidence, risk factors, and epidemiological trends of tracheal cancer: a global analysis

BackgroundTracheal cancer is a rare malignancy with limited research but high mortality rates. This study aims to analyse recent data to understand the global burden, trends, and risk factors for tracheal cancer, facilitating improved prevention and treatment strategies.MethodsWe conducted a study on tracheal cancer using data from the Global Cancer Observatory and the Cancer Incidence in Five Continents databases. We collected information on the incidence of tracheal cancer, risk factors, and the Human Development Index (HDI) at the country level. The univariate linear regression was used to explore the relationship between tracheal cancer and the various risk factors. We utilised joinpoint regression analysis to calculate the Average Annual Percentage Change (AAPC) in tracheal cancer incidence.ResultsThe global age-standardised rate of incidence of tracheal cancer was 2.9 per 10 million (3,472 cases in total) in 2022, with the highest regional incidence observed in Central and Eastern Europe (ASR = 9.0) and the highest national incidence in Hungary (12.5). Higher incidence was found among the males (3.8) than females (2.0); among the older adults aged 50-74 (11.9) than the younger population aged 15-49 (1.2). A higher tracheal cancer incidence ratio was associated with higher levels of smoking, alcohol drinking, diabetes, lipid disorders, and HDI. Despite the overall decreasing trends for all population groups (highest decrease in Thailand; AAPC: -15.06, 95% CI: -21.76 to -7.78, p = 0.002), there was an increase in some female populations (highest increase in Colombia, AAPC: 19.28, 95% CI: 16.48 to 22.15, p < 0.001) and younger populations (highest increase in Ireland; AAPC: 29.84, 95% CI: 25.74 to 34.06, p < 0.001).ConclusionThis study provides a comprehensive analysis of tracheal cancer, focusing on risk factors and population-level trends. There has been an overall decreasing trend in the incidence of tracheal cancer, particularly among males and older adults, while the decline is less pronounced in females and younger individuals. Further research is needed to explore the underlying drivers of these epidemiological trends.

Trends in Sudden Cardiac Death Among Adults Aged 25 to 44 Years in the United States: An Analysis of 2 Large US Databases.

Sudden cardiac death (SCD) in early adults aged 25 to 44 years represents an important and unexpected cause of death. We assessed trends in SCD-related mortality in the United States from 1999 to 2020 among early adults to determine differences by sex, ethnoracial groups, urbanization, and census region. Mortality data were retrieved from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data set from 1999 to 2020. Age-adjusted mortality rates were assessed using the Joinpoint regression modeling and expressed as estimated average annual percentage change with relative 95% CIs. Trends in prevalence of coronary artery disease/myocardial infarction, heart failure, and stroke, which may have contributed to SCD-related mortality over the same period, were obtained from the National Health and Nutrition Examination Survey. From 1999 to 2020, 10 516 US early adults aged 25 to 44 years had SCD (7832 men and 2684 women), resulting in 3.72 deaths per 1000 population, or a mean of 478 deaths annually. The relative age-adjusted mortality rate increased linearly (average annual percentage change: +1.0% [95% CI, 0.3-1.8]), without sex differences. The age-adjusted mortality rate increase was more pronounced in Black patients, Hispanic/Latinx patients, and residents of rural areas. Higher absolute numbers of SCDs were clustered in the South (47.6%). During the same period, the prevalence of coronary artery disease/myocardial infarction, heart failure, and stroke plateaued. SCD-related mortality associated with opioids/stimulants overdose significantly increased over the entire study period. SCD-related mortality among early adults has increased over the last 2 decades in the United States with notable racial and regional disparities.

Bayesian age-period-cohort projection of cancers in Iran: a modeling study

IntroductionCancer is a significant public health issue in Iran, and its incidence has been on the rise in recent years. The objective of this study is to predict the incidence of total cancer in Iran using a Bayesian age-period-cohort (APC) model.MethodsUtilizing age-period-cohort modeling, this study assessed the multifaceted effects of age, period, and cohort on cancer incidence during the period spanning 2005 to 2017. Key metrics, including the net drift (representing the overall annual percentage change), local drift (indicating annual percentage changes within specific age groups), and longitudinal age curves (depicting expected age-specific rates over time), were computed. Moreover, the evaluation encompassed an analysis of period and cohort relative risks. To project the future age-standardized incidence rates of cancers from 2018 to 2027, Bayesian age-period-cohort analysis integrated nested Laplace approximations.ResultThe age-standardized incidence rate and the absolute number of cancer cases in Iran showed an upward trend. The net drift was 1.79% (95% confidence interval, CI: 0.87% to 2.72%) for males and 3.31% (95% CI: 2.49% to 4.14%) for females. Local drifts remained consistently above zero for all age groups from 2005 to 2017, except for the under-5 age group in both males and females, and the 45–49 and 50–54 age groups in females. After accounting for period deviations, the risk of cancer incidence exhibited an exponential increase with age for both sexes. Based on the Bayesian age-period-cohort analysis, it is estimated that there will be around 210,701 new cancer cases in 2027. Moreover, the Age-Standardized Rate (ASR) for cancer is anticipated to reach 240.32 per 100,000 by 2027. The forecasts indicate a rise in cancer incidence rates across all age groups for both males and females.ConclusionThis study underscores the urgency of implementing targeted preventive strategies aligned with demographic shifts and lifestyle factors. Emphasizing the role of robust cancer registries, it advocates for continuous monitoring to inform evidence-based interventions.

On the convergence of credit risk in current consumer automobile loans

Abstract Risk-based pricing within consumer lending is ubiquitous. It considers both prevailing interest rates and the credit profile of a borrower to determine the cost of borrowing. All else equal, higher default risks pay higher borrowing costs. This cost is the annual percentage rate (APR), and it is set at the loan’s origination. A borrower’s credit profile is dynamic, however, and the risk of default gradually declines for current loans. In this article, we derive a novel large-sample statistical hypothesis test suitable for loans sampled from asset-backed securities to populate a credit risk transition matrix between consumer credit risk groups. We find that current loans in all risk groups eventually converge to the top credit tier before scheduled termination, a phenomenon we call credit risk convergence. We then use these convergence estimates for two empirical economic studies. We first estimate that lender conditional risk-adjusted expected profits significantly increase as high-risk, high-APR borrowers stay active and paying. We then estimate current borrowers are entitled to $1,153–2,327 in potential credit-based savings from their improving risk profiles. Because we study consumer auto loans, a large-scale and essential economic good, we opine on the social implications of these results and suggest areas of further study.

Trends in complications of cardiac and vascular prosthetic devices, implants, and grafts mortality rate in the United States (1999–2020)

To analyze mortality rates due to complications of cardiac and vascular prosthetic devices, implants, and grafts in the United States, International Classification of Diseases, Tenth Revision, codes were used on the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to retrieve death certificate data between the years 1999 and 2020 for patients aged 55 and above. Age-adjusted mortality rates (AAMRs), per 100 000 people, and annual percentage change along with their respective 95% confidence intervals were also calculated. Complications of cardiac and vascular prosthetic devices, implants, and grafts were responsible for 91 539 deaths among adults aged 55 years and older. The overall AAMR decreased from 9.2 in 1999 to 3.4 in 2020. AAMRs for men were higher than for women (overall AAMR men: 7.5; women: 4.5). Stratifying patients according to race the order of AAMRs from highest to lowest was as follows: non-Hispanic Black or African American (6.8), NH White: (5.9), NH American Indian or Alaska Native (5.7), Hispanic or Latino (4.0) and lastly NH Asian or Pacific Islander (3.2). State wise the top 90th percentile states with regard to mortality included West Virginia, South Carolina, Mississippi, North Dakota, and Alabama. In census regions the South had the highest AAMR (6.2) followed by the Midwest (6.0), the Northeast (5.4), and the West (5.1) with nonmetropolitan areas having higher AAMRs (7.0) than metropolitan areas (5.4). Further research and a more individualized pattern of treatment of older patients are necessary moving forward.

A systematic analysis of the burden of disease attributable to occupational noise-induced hearing loss in China based on the 2019 global burden of disease study

BackgroundOccupational noise has long been recognized as a significant risk factor for hearing loss, particularly among workers. This study aimed to assess the disease burden of hearing loss caused by occupational noise in China from 1990 to 2019, with a focus on differences across sex and age groups, so as to address the existing gaps in the Global Burden of Disease Study (GBD) reports. By analyzing changes in years lived with disability (YLDs) among different sex and age groups over the past 30 years, this study provides valuable insights for the development of occupational noise safety measures in China.MethodsWe extracted data on the burden of hearing loss attributable to occupational noise from the 2019 Global Burden of Disease study. R software (version 4.12) was used to calculate the YLDs, age-standardized rates (ASRs), and average annual percent change (AAPC), stratified by age and sex. The Joinpoint regression model was used to analyze the trends in the burden of disease attributable to occupational noise exposure from 1990 to 2019.ResultsIn China, the YLDs attributable to occupational noise-induced hearing loss in 2019 were 2.3277 million [95% uncertainty interval (UI): 1.5779–3.3478 million, marking a 70.95% increase compared with that in 1990. Throughout the study period, YLD rates exhibited a declining trend, with rates of 127.7 per 100,000 (95% UI: 87.4–181.4) in 1990 and 119.8 per 100,000 (95% UI: 81.2–182.1) in 2019. Using the Joinpoint regression model, the annual percent change (APC) in age-standardized YLD rates for occupational noise-related hearing loss initially increased from 1990 to 2000, followed by a decline, reaching its lowest point in 2015. From a sex perspective, the burden of YLDs in Chinese males exceeded that in females, although the rate of decline was less pronounced in females. With regard to age, the number and rate of YLDs attributable to occupational noise-induced hearing loss generally increased with age, particularly among middle-aged individuals and older adults. However, from 1990 to 2019, the number of YLDs attributable to occupational noise-induced hearing loss decreased among young people aged 15–19 years, accompanied by a significant reduction in YLDs rates.ConclusionHearing loss attributable to occupational noise represents a substantial public health concern, especially among middle-aged and older adult workers in China. These findings underscore the importance of implementing effective measures to mitigate occupational noise exposure.

Current status and trends in thalassemia burden across South, East and Southeast Asia, 1990–2021 a systematic analysis for the global burden of disease study 2021

ObjectiveThalassemia, an inherited hemoglobin synthesis disorder, imposes a significant health burden in Asian regions with high prevalence. Detailed patterns and trends of the disease across countries and territories within these regions remain underexplored. Our study focuses on the disease burden indices of thalassemia within the four GBD-defined Asian regions and the twenty-five included countries and territories. It provides insights into the gender-age distribution, temporal changes, and economic aspects of the thalassemia burden.MethodsData on thalassemia prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) were extracted from the Global Burden of Disease (GBD) 2021 study for South, East, Southeast, and high-income Asia regions, encompassing the relevant countries and territories from 1990 to 2021. The Average Annual Percent Change (AAPC) in age-standardized rates of thalassemia was determined to assess temporal trends. Age-gender cohort proportions were considered. The economic aspect of the disease burden and frontier analysis were evaluated using the GBD Socio-Demographic Index and Global Health Expenditure data.ResultsSoutheast Asia exhibited notably high age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate among the four studied Asian regions in 2021. The East Asia region had recorded the highest age-standardized incidence rate (ASIR). A general decline in disease burden indices across the four regions from 1990 to 2021 was evident, with the exception of ASIR in Southeast Asia. The ASMR was highest among pediatric population under five years old, with a significant male preponderance. An unusual increase in ASMR was detected among females of childbearing age and the elderly within the studied region. Further analysis had identified six high-burden countries and territories, particularly those with low-middle Socio-Demographic Index (SDI) rankings and limited health expenditure.ConclusionAlthough the overall burden of thalassemia has decreased substantially, the disease burden was influenced by gender, age, geography, temporal trends, and economic factors in distinct manners. Based on the current SDI, many countries and regions still have greater improvement potential in the disease burden. There is a necessity for enhanced attention and resource allocation, particularly in low-middle and low SDI countries, with an emphasis on policies that promote early diagnosis and comprehensive care.

Trends and Disparities in Cardiovascular Disease-Related Mortality among Adults with Myeloproliferative Neoplasms in the United States

Abstract Aims We aimed to perform a retrospective cohort study using the Centers for Disease Control and Prevention`s (CDC's) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database to analyze the trends in cardiovascular disease (CVD)-related mortality in patients with myeloproliferative neoplasms (MPN) from 1999-2020. Methods and Results We analyzed the death certificate data from the CDC WONDER database from 1999 to 2020 for CVD with co-morbid myeloproliferative disorders in the US population. Age-adjusted mortality rates (AAMR) and 95% confidence intervals (CIs) were computed per 1 million population by standardizing crude mortality rates to the 2000 US census population. To assess annual national mortality trends, we employed the Joinpoint regression model, calculating the annual percent change (APC) in AAMR and corresponding 95% CIs. A total of 15,269 deaths related to CVD occurred in patients with co-morbid myeloproliferative neoplasms from 1999-2020. Overall, there was a decreasing trend in CVD-related AAMRs throughout these years. Males contributed to 51% of total deaths and their AAMR was persistently higher than women throughout the study. Non-Hispanic (NH) Whites had the highest overall AAMR, followed by NH Blacks, NH American Indians or Alaska Natives, Hispanics or Latinos, and NH Asian or Pacific Islanders. Conclusion Our findings indicate a significant decline with notable gender, racial/ethnic, and regional differences in CVD-related mortality among patients with MPN over the past two decades. We emphasize the importance of a collaborative approach between oncologists and cardiologists in managing these patients, highlighting the potential benefits of integrating cardio-oncology services to enhance patient outcomes.

Epidemiological shifts in chronic kidney disease: a 30-year global and regional assessment

BackgroundChronic kidney disease (CKD) presents a growing global health challenge, with significant variability in disease burden across different regions and countries. This study aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for CKD from 1990 to 2019, utilizing data from the Global Burden of Disease Study.MethodsWe conducted an in-depth study on the global and age-standardized incidence, prevalence, mortality, and DALYs of CKD, and assessed trends over a 30-year period. Additionally, we explored the associations between healthcare access and quality (HAQ), the Socio-Demographic Index (SDI), and CKD. Furthermore, we conducted a detailed analysis of six risk factors closely related to CKD, and based on these findings, provided strong evidence for enhancing the management of CKD.ResultsIn 2019, there were 18,986,903 cases of CKD, with an average annual percent change (AAPC) of 1.82 (95% CI = 1.8 to 1.82) in incidence since 1990. The age-standardized incidence rate increased from 192.45 per 100,000 in 1990 to 233.65 per 100,000 in 2019. Prevalence also rose, with a total of 69,729,430 cases in 2019 and an AAPC of 1.19 (95% CI = 1.19 to 1.2). Mortality and DALYs have increased correspondingly, with the mortality rate reaching 18.29 per 100,000 and total DALYs at 41,538,592 in 2019. The analysis showed that higher HAQ levels are associated with better outcomes in terms of lower mortality and DALY rates, whereas lower HAQ levels correlate with poorer outcomes. In addition, high fasting plasma glucose and high systolic blood pressure are the main contributors to CKD-related deaths, with their population attributable fraction (PAF) significantly decreasing as the SDI decreases.ConclusionThe burden of CKD has significantly increased over the past three decades, influenced by demographic changes and variations in healthcare quality and access. Effective public health strategies and improvements in healthcare delivery are needed to address the disparities in CKD outcomes globally.

Smoking-attributable peptic ulcer disease mortality worldwide: trends from 1990 to 2021 and projections to 2046 based on the global burden of disease study

ObjectiveSmoking is a major risk factor for peptic ulcer disease (PUD) mortality. This study aims to analyze global trends in smoking-attributable PUD mortality from 1990 to 2021 and project future trends to 2046.MethodsData were obtained from the Global Burden of Disease Study 2021. We calculated age-standardized mortality rates (ASMR) and estimated annual percentage changes (EAPC) for smoking-attributable PUD mortality. Bayesian Age-Period-Cohort models were used to project future trends.ResultsFrom 1990 to 2021, global smoking-attributable PUD deaths decreased from 48,900 to 29,400, with the ASMR declining from 1.2 to 0.3 per 100,000 (EAPC: −4.25%). High-income regions showed faster declines, while some low- and middle-income countries experienced slower progress or even increases. Projections suggest a continued global decline in smoking-attributable PUD mortality to 2046, with persistent regional disparities. By 2046, the global ASMR is expected to decrease to approximately 0.1 per 100,000, with higher rates persisting in certain regions such as the Solomon Islands (3.7 per 100,000) and Cambodia (1.6 per 100,000).ConclusionWhile global smoking-attributable PUD mortality has significantly decreased and is projected to continue declining, substantial regional disparities persist. These findings underscore the need for targeted tobacco control interventions, particularly in high-risk regions, to further reduce the global burden of smoking-attributable PUD mortality.

The Burden of Peripheral Artery Disease in China From 1990 to 2019 and Forecasts for 2030: Findings From the Global Burden of Disease Study 2019

ObjectivesThe incidence of peripheral arterial disease (PAD) in China is increasing. We aim to conduct a comprehensive analysis of the burden of PAD.MethodsWe collected information from 1990 to 2019 in the Global Burden of Disease (GBD 2019) study. Joinpoint regression analysis was used to calculate the annual percentage change (APC). Trends in incidence, mortality and DALYs were forecasted by Bayesian age-period-cohort (BAPC) analysis.ResultsIn 2019, the number of new cases and prevalence of PAD in China accounted for nearly a quarter of the global proportion. The age-standardized incidence rate (ASIR) declined after rising until 2005. The age-standardized death rate (ASDR) maintained an upward trend. The DALYs was 0.16 million. Incidence, prevalence and DALYs are predominantly female, except for mortality, which is predominantly male. Smoking predominantly affected males, while hypertension and diabetes had a greater impact on females. By 2030, ASDR is elevated, predominantly in males. ASIR and age-standardized DALY rate decline, predominantly in females.ConclusionIt is urgent for China to develop strategies based on the specific distribution characteristics of the PAD burden.

Global, regional and national disease burden of food-borne trematodiases: projections to 2030 based on the Global Burden of Disease Study 2021

BackgroundFood-borne trematodiases (FBTs), mainly encompassing clonorchiasis, fascioliasis, fasciolopsiasis, opisthorchiasis, and paragonimiasis, is a neglected public health problem, particularly in the WHO South-East Asia and the Western Pacific regions. This study evaluates the global, regional, and national disease burden of FBTs from 1990 to 2021 and projects trends to 2030, underscore the need for targeted prevention and control.MethodsUsing the Global Burden of Disease 2021 database, the crude and the age-standardized prevalence rate (ASPR) and age-standardized prevalence disability-adjusted life years rate (ASDR) of FBTs at the global, regional and national level from 1990 to 2021 were described. The pivotal years of trend changes were identified using joinpoint regression analysis. The effects of age, period, cohort on FBTs prevalence and correlation with the sociodemographic index (SDI) was analyzed. Finally, the worldwide disability-adjusted life years (DALYs) for FBTs, projected up to 2030 using the Bayesian age-period-cohort model, were analyzed.ResultsIn 2021, 44,466,329 FBTs cases [95% uncertainty interval (UI): 40,017,217, 50,034,921], and 998,028 DALYs [95% UI: 569,766, 1,638,112] were estimated across 17 countries. The Western Pacific region exhibited the highest ASPR and ASDR, with the values of 1649.26 (95% UI: 1461.95, 1881.64) and 36.54 (95% UI: 19.77, 64.16), respectively. From 1990 to 2021, Lao PDR, Thailand, and the Philippines showed the most substantial declines in FBTs, while Kazakhstan had the largest average annual percentage change in DALYs (− 6.60, 95% UI: − 7.10, − 6.10). High-middle and middle SDI countries exhibited higher burden, with ASDR values of 28.03 (95% UI: 15.41, 48.73) and 16.63 (95% UI: 9.32, 27.68), respectively. The disease burden was greater among males, peaking in the 50–59 age group. The projected ASDR in 2030 is 13.10 for males and 8.40 for females.ConclusionsFBTs remain a public health threat, with the global ASDR projected to remain stable, showing only a slight decrease by 2030. Low-income countries face ambiguous mortality rates and underestimated disease burdens, highlighting the need for improved surveillance. To achieve the 2030 NTD goal, comprehensive surveillance and integrated strategies derived using a One Health approach should be prioritized to control FBTs effectively.Graphical

Alcohol-related injury hospitalisations in relation to alcohol policy changes, Northern Territory, Australia, 2007-2022: A joinpoint regression analysis.

The Northern Territory (NT) of Australia has the highest rates of alcohol consumption and injury in the country. We aimed to: (i) describe the epidemiology of alcohol-related injury (ARI) hospitalisations in the NT; (ii) estimate the proportion of alcohol involvement in injury hospitalisations; and (iii) consider the influence of alcohol policies on ARI hospitalisation trends. We conducted a retrospective time-series study using coded hospitalisation data from NT public hospitals between 2007 and 2022. ARI hospitalisation was defined combining indicators for injury and acute alcohol use. We undertook descriptive analyses and calculated alcohol involvement against all injury hospitalisations. Annual percent changes (APC) were computed using joinpoint regression to examine the influence of alcohol policies on ARI hospitalisation trends by NT geographical regions (Central Australia and Top End). Alcohol use was associated with 22.6% of all injury hospitalisations. The most common cause of ARI hospitalisations was assault (46%). In Central Australia, a significant trend decline (APC -12.2; p = 0.011) was observed after 2017 following alcohol policies implemented between 2017 and 2018 (Banned Drinkers Register v2; Minimum Unit Price; and Police Auxiliary Liquor Inspectors). Consecutive years with the greatest decrease in Central Australia were 2013-2014 (APC -25.8) and 2018-2019 (APC -35.1); likely influenced by alcohol policies in effect at the time. In the Top End, a non-significant trend decline (APC -26.1; p = 0.186) was observed after 2020. Alcohol policies implemented between 2017 and 2018 were associated with reduced ARI hospitalisations in Central Australia. Alcohol policies that demonstrated reduced harm should be sustained.

Burden of chronic obstructive pulmonary disease attributable to ambient ozone pollution across China and its provinces, 1990-2021: An analysis for the Global Burden of Disease Study 2021.

Epidemiological studies have demonstrated a causal relationship between ambient ozone (O3) and mortality from chronic obstructive pulmonary disease (COPD), which is the only outcome considered in the Global Burden of Disease Study 2021 for O3. This study aims to evaluate the temporal trend and spatial distribution of the COPD burden attributable to O3 across China from 1990 to 2021. The ambient O3 concentrations in China were estimated. Based on the methodology framework and standard analytical methods applied in the Global Burden of Disease Study 2021, we estimated the annual number, age-standardized rate, and percentage of deaths and disability-adjusted life-years (DALYs) from COPD attributable to O3 pollution during 1990-2021 at the national and provincial levels in China. In 2021, a total of 125.7 (95% uncertainty interval [UI], 26.4-228.3) thousand deaths and 1917.5 (95% UI, 398.7-3504.6) thousand DALYs from COPD were attributable to ambient O3 pollution in China, accounting for 9.8% (95% UI, 2.1-17.0%) and 8.1% (95% UI, 1.8-14.1%) of the total COPD deaths and DALYs, respectively. Generally, a higher burden was observed among males, the elderly, and the population residing in regions with worse health conditions. The age-standardized rates of COPD deaths and DALYs per 100,000 populations ranged from 0.5 (95% UI, 0-1.4) and 8.1 (95% UI, 0.7-20.9) in Hong Kong to 22.8 (95% UI, 3.9-43.5) and 396.6 (95% UI, 68.9-763.7) in Xizang. From 1990 to 2021, there was a notable decrease in the age-standardized rates of COPD deaths (68.2%, 95% UI, 60.1-74.9%) and DALYs (71.5%, 95% UI, 63.7-77.6%), especially in regions with poor health conditions. However, the attributable numbers and percentages changed relatively marginally. Ambient O3 pollution is a major contributor to the COPD burden in China. Our findings highlight the significant spatial heterogeneity across different provinces and underscore the implementation of geographically tailored policies to effectively reduce O3 pollution and alleviate the associated disease burden.