Number Of Years Of Life Lost Research Articles

Sociodemographic features of COVID-19 premature mortality: Serbian individual-level data evidence

Abstract Background In Serbia, premature mortality due to COVID-19 usually has been assessed using aggregated mortality data, thus overlooking the impact of sociodemographic factors. Within the European Burden of Disease Network (COST Action CA18218), we examined the association between several sociodemographic factors and COVID-19 years of life lost (YLL) to reveal potential social inequalities. Methods The Statistical Office of the Republic of Serbia (SORS) has provided disaggregated, anonymized, and individual data on COVID-19 deaths in 2020 and 2021 from death certificates having U07.1 and U07.2 ICD codes as the main cause of death. Additionally, SORS remaining life expectancy and population size estimates were used along with sociodemographic data for each YLL case (sex, time and place of death, type of residential settlement, educational attainment, marital status, and economic activity). Results In the observed two-year period, 38,098 COVID-19 death cases were assessed, of which 72.8% were registered in 2021. The average YLL per death case was 12.51±7.62, and the median YLL was 11.50 (12.60±7.44 for men and 12.39±7.85 for women, p < 0.006). The multivariate linear regression indicated a significant association between the number of YLL and sex (B = 1.02, p < 0.01), residential area (B = 0.21, p < 0.01), educational attainment (B = 0.84, p < 0.01), marital status (B = 1.65, p < 0.01), employment (B=-7.02, p < 0.01) and place of death (B=-1.76, p < 0.01). Conclusions This study demonstrates social inequalities in COVID-19 premature mortality associated with the highest YLL among men, single persons, retired persons, and those with higher education status. We identify significant differences in YLL when comparing different regions. Key messages • Individual-level data reveals differences in premature mortality aggravated by social disparities. • Policymakers should consider sociodemographic factors when designing COVID-19 prevention measures.

The burden of premature mortality among older adults: a population-based study in Malaysia

BackgroundThe populations of many countries—including Malaysia—are rapidly growing older, causing a shift in leading causes of disease and death. In such rapidly ageing populations, it is critical to monitor trends in burden of disease and health of older adults by identifying the leading causes of premature mortality and measuring years of life lost (YLL) to these. The objective of this study, therefore, is to describe the burden (quantified by YLL) associated with major causes of premature mortality among older adults in Malaysia in 2019.MethodsAll deaths that occurred in older adults aged 60 and above in Malaysia in the year 2019 were included in this study. YLL was calculated by summing the number of deaths for the disease category at 5-year age intervals, multiplied by the remaining life expectancy for the specific age and sex group. Both life expectancy and mortality data were obtained from the Department of Statistics Malaysia.ResultsIn 2019, older adults accounted for 67.4% of total deaths in Malaysia (117,102 out of 173,746). The total number of YLL among older adults in Malaysia in 2019 was estimated at 1.36 million YLL, accounting for 39.6% of the total YLL (3.44 million) lost to all premature deaths in that year. The major causes of premature mortality among older adults were ischaemic heart disease (29.5%) followed by cerebrovascular disease (stroke) (20.8%), lower respiratory infections (15.9%), diabetes mellitus (8.1%) and trachea, bronchus and lung cancers (5.0%).ConclusionsNon-communicable diseases (NCD) remained the largest contributor to premature mortality among older adults in Malaysia. Implementation of population-level NCD health promotion programmes, screening programmes among high-risk groups and holistic intervention programmes among populations living with NCD are critical in reducing the overall burden of premature mortality.

Years of life lost associated with COVID-19 deaths in the USA during the first 2 years of the pandemic.

BackgroundPrior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic.MethodsWe employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs.ResultsWe estimated roughly 9.7 million YLLs due to COVID-19 deaths. The number of YLLs per 10 000 capita was 297.5, with the highest rate in Mississippi (482.7) and the lowest in Vermont (61.4). There was substantial interstate variation in the timing of YLLs and differences in YLLs by gender. YLLs per death increased from 9.2 in the first year of the pandemic to 10.8 through the first 2 years.ConclusionsOur findings improve our understanding of how the mortality effects of COVID-19 have evolved. This insight can be valuable to public health officials as the disease moves to an endemic phase.

Years of life lost by COVID-19 in Portugal and comparison with other European countries in 2020

BackgroundThe impact of the COVID-19 pandemic has been measured in different metrics, mostly by counting deaths and its impact on health services. Few studies have attempted to calculate years of life lost (YLL) to COVID-19 and compare it with YLL due to other causes in different countries.MethodsWe calculated YLL to COVID-19 from week10 to week52 in 2020 for eight European countries by methods defined by the WHO. We calculated excess YLL by subtracting the average YLL from 2017 to 2019 to the YLL in 2020. Our analysis compared YLL to COVID-19 and the excess YLL of non-COVID-19 causes across countries in Europe.ResultsPortugal registered 394,573 cases and 6619 deaths due to COVID-19, accounting for 25,395 YLL in just 10 months. COVID-19 was responsible for 6.7% of all deaths but accounted for only 4.2% of all YLL. We estimate that Portugal experienced an excess of 35,510 YLL (+ 6.2%), of which 72% would have been due to COVID-19 and 28% due to non-COVID-19 causes. Spain, Portugal, and the Netherlands experienced excess YLL to non-COVID-19 causes. We also estimated that Portugal experienced an excess of 10,115 YLL due to cancer (3805), cardiovascular diseases (786) and diseases of the respiratory system (525).ConclusionCOVID-19 has had a major impact on mortality rates in Portugal, as well as in other European countries. The relative impact of COVID-19 on the number of deaths has been greater than on the number of YLL, because COVID-19 deaths occur mostly in advanced ages.

The impact of pharmaceutical innovation on the burden of disease in Canada, 2000-2016.

We perform an econometric assessment of the role that pharmaceutical innovation—the introduction and use of new drugs—has played in reducing the burden of disease in Canada, by investigating whether diseases for which more new drugs were launched had larger subsequent reductions in disease burden. Since utilization of a drug reaches a peak about 12–14 years after it was launched, we allow for considerable lags in the relationship between new drug launches and the burden of disease.We analyze the impact of new drug launches on a comprehensive measure of disease burden—the age-standardized disability-adjusted life-years lost (DALY) rate—and on its two components: the age-standardized years of life lost (YLL) and years lost to disability (YLD) rates. We also analyze the impact of new drug launches on the number of hospital discharges and on the average length of hospital stays.The number of DALYs lost is significantly inversely related to the number of drugs that had ever been launched 9–20 years earlier, and the number of YLLs is significantly inversely related to the number of drugs that had ever been launched 11–20 years earlier. The launch of a drug has the largest (most negative) impact on the number of DALYs and YLLs 15 years after it was launched.The estimates indicate that if no drugs had been launched during 1986–2001, the age-standardized DALY rate would not have declined between 2000 and 2016; it might even have increased. Almost all (93%) of the reduction in DALYs was due to a reduction in YLL. The estimates imply that new drug launches during 1986–2001 reduced DALYs in 2016 by 21%, reduced YLLs in 2016 by 28%, and reduced YLDs in 2016 by 3%.We estimate that drugs launched during 1986–2001 reduced the number of DALYs lost in 2016 by 2.31 million. Expenditure in 2016 on drugs launched during 1986–2001 per DALY gained in 2016 from those drugs was 2842 USD. Interventions that avert one DALY for less than average per capita income for a given country or region are generally considered to be very cost–effective; Canada's per capita GDP was 42,158 USD in 2016, so our estimates indicate that the new drugs launched during 1986–2001 were very cost–effective, overall.Moreover, 2842 USD may be an overestimate of the true net cost in 2016 per DALY of drugs launched during 1986–2001. A previous study based on U.S. data showed that about 25% of the cost of new drugs is offset by reduced expenditure on old drugs. Also, our estimates indicate that, if no drugs had been launched during 1986–2001, the average length of 2016 hospital stays would have been about 16% higher. The reduction in hospital expenditure due to shorter average length of stay may have been larger than the expenditure on the drugs responsible for shorter hospital stays.

A comprehensive analysis on expected years of life lost due to pancreatic cancer

Pancreatic cancer represents a fatal malignancy leading to premature death and loss of life expectancy. The aim of the present study was to assess how many years of life are lost due to this cancer, in relationship with surgery and ageing. Data from 716 consecutive patients discharged from a tertiary referral hospital (2002-2012) with a diagnosis of pancreatic cancer and with complete clinical and follow-up data were used to estimate the number of years of life-lost (YLL) through a semi-parametric extrapolation having an age-, sex- and year-of-onset- matched population derived from national life tables as reference. The mean entire lifespan estimated for the 716 patients was 1.4 years (95% C.I.:0.8-1.9) resulting in a number of YLL after diagnosis of 12 years (95% C.I.:11.5-12.6) per person. Surgical patients (147 cases; 20.5%) were younger and experienced higher post-diagnostic lifespan (3.5 years) than non-surgical older individuals (0.8 years; p<0.001). These figures were reflected on the number of expected YLL (EYLL) that remained substantially unaffected by surgery (p=0.821). Patients aged ≤68 years experienced the highest number of EYLL (20.8 years); whereas elderly patients had a loss of life that corresponded to only 6% of the entire life they had already lived. In a typical pancreatic cancer cohort, surgery was not able to modify population-based statistics because of a different age at tumor onset which nullifies any benefit from a "lifespan from birth" perspective. Pancreatic cancer in younger individuals must be ranked within the very first causes of EYLL due to malignancy.

Premature mortality due to cancer in Japan, 1995 and 2005

To better understand premature mortality due to cancer, we estimated years of life lost (YLL) and average years of life lost (AYLL) due to cancer for the years 1995 and 2005, based on data from the Vital Statistic of Japan. In men, we identified a total of 159,623 cancer deaths in 1995 and 196,603 in 2005. Total YLL were 2,342,560.4 and 2,724,066.0 years, respectively. Averaged for all cancers, people died 14.7 years earlier than life expectancy in 1995 and 13.9 years in 2005. AYLL was longest for brain cancer deaths, at 26.3 years earlier than expected in 1995 and 22.8 years in 2005, followed by leukemia. In women, a total of 103,399 cancer deaths occurred in 1995 and 129,338 in 2005. Total YLL were 1,818,960.4 years in 1995 and 2,160,706.5 years in 2005, corresponding to AYLL for all cancer combined of 17.6 and 16.7 years. The AYLL of brain cancer deaths was also the longest, at 29.4 years in 1995 and 27.8 in 2005, followed by leukemia and female sex-related cancers. Results showed that cancer of the stomach, colorectum, liver and lung were the most frequent cancers in both sexes in both 1995 and 2005 and responsible for a remarkable number of YLL. Further, AYLL was greatest for brain cancer and leukemia in both sexes and for sex-related cancers in women, namely breast, cervix and ovarian cancer.