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Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019

Nature communications 2025年第1期16卷 4235-4235页

作者： Cecilia Anza-Ramirez J. Jaime Miranda Benedetta Armocida Jorge César Correia Harriette Gillian Christine Van Spall David Beran Amirali Aali Kalkidan Hassen Abate Semagn Mekonnen Abate Cristiana Abbafati Mohsen Abbasi-Kangevari Zeinab Abbasi-Kangevari Zahra Aryan Sina Azadnajafabad Mohammadreza Azangou-Khyavy Seyyed-Hadi Ghamari Mohammad Keykhaei Javad Khanali Sara Momtazmanesh Fateme Montazeri Shayan Rahmani Mohammad-Mahdi Rashidi Nazila Rezaei Negar Rezaei Sahar Saeedi Moghaddam Hossein Hassanian-Moghaddam Ali-Asghar Kolahi Ali Nikoobar Hedayat Abbastabar Ahmed M. Abdel-Azeem Michael Abdelmasseh Juan Sanabria Sherief Abd-Elsalam Ahmed Abdelwahab Gholamreza Abdoli Mohammad Abdollahi Meriem Abdoun Deldar Morad Abdulah Abu Yousuf Md Abdullah Ame Mehadi Abdurehman Getachew Abebe Aidin Abedi Chirag P. Doshi Vida Abedi Hassan Abidi Richard Gyan Aboagye Hassan Abolhassani Nima Rezaei Lucas Guimarães Abreu Michael R. M. Abrigo Yonas Derso Abtew Hiwa Abubaker Ali Eman Abu-Gharbieh Hiba Jawdat Barqawi Rabih Halwani Maha Mohamed Saber-Ayad Iman M. Talaat Ahmed Abu-Zaid Manfred Mario Kokou Accrombessi Juan Manuel Acuna Denberu Eshetie Adane Tigist Demssew Adane Isaac Yeboah Addo Giovanni Addolorato Oluwafemi Atanda Adeagbo Victor Adekanmbi Miracle Ayomikun Adesina Isaac Iyinoluwa Olufadewa Olatunji O. Adetokunboh Daniel Adedayo Adeyinka Qorinah Estiningtyas Sakilah Adnani Aanuoluwapo Adeyimika Afolabi Olayinka Stephen Ilesanmi Muhammad Sohail Afzal Saira Afzal Gina Agarwal Prerna Agarwal Pradyumna Agasthi Anurag Agrawal Marcela Agudelo-Botero Adolfo Martinez-Valle Bright Opoku Ahinkorah Aqeel Ahmad Sajjad Ahmad Sohail Ahmad Tauseef Ahmad Ali Ahmadi Siamak Sabour Keivan Ahmadi Sanjay Basu Sepideh Ahmadi Ali Ahmed Shaun Wen Huey Lee Ayman Ahmed Haroon Ahmed Jivan Qasim Ahmed Gahin Abdulraheem Tayib Yahya Yahya Luai A. Ahmed Iffat Elbarazi Syed Mahboob Shah Janardhana P. Aithala Marjan Ajami Budi Aji Hossein Akbarialiabad Yibeltal Akelew Meisam Akhlaghdoust Elham Jamshidi Addis Aklilu Azene Tesfaye Melat Woldemariam Maxwell Ak CRONICAS Center of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia Lima Peru School of Medicine Universidad Peruana Cayetano Heredia Lima Peru Sydney School of Public Health Faculty of Medicine and Health University of Sydney Sydney NSW Australia Faculty of Epidemiology and Population Health London School of Hygiene & Tropical Medicine London UK Division of Tropical and Humanitarian Medicine University of Geneva Geneva Switzerland Department of Cardiovascular Endocrine-metabolic Diseases and Aging Istituto Superiore di Sanità Rome Italy Division of Endocrinology Diabetology Nutrition and Therapeutic Patient Education Department of Medicine Geneva University Hospitals Geneva Switzerland Department of Medicine and Department of Health Research Evidence and Impact McMaster University Hamilton ON Canada Research Institute of St. Joe’s Hamilton ON Canada Population Health Research Institute Hamilton Canada Geneva University Hospitals Geneva Switzerland Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran Department of Nutrition and Dietetics Jimma University Jimma Ethiopia Anesthesiology Department Dilla University Addis Ababa Ethiopia Department of Juridical and Economic Studies La Sapienza University Rome Italy Non-Communicable Diseases Research Center Tehran University of Medical Sciences Tehran Iran Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran Brigham and Women’s Hospital Harvard University Boston MA USA Students’ Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran School of Medicine Tehran University of Medical Sciences Tehran Iran School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran Endocrinology and Metabolism Research Institute Tehran University of Medical Sciences Tehran Iran Chapter of Addiction Medicine University of Sydney Sydney NSW Australia Advanced Diagnostic and Intervent

Chronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly. © 2025. The Author(s).

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Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021

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LANCET NEUROLOGY 2024年第4期23卷 344-381页

作者： Steinmetz, Jaimie D. Seeher, Katrin Maria Schiess, Nicoline Nichols, Emma Cao, Bochen Servili, Chiara Cavallera, Vanessa Cousin, Ewerton Hagins, Hailey Moberg, Madeline E. Mehlman, Max L. Abate, Yohannes Habtegiorgis Abbas, Jaffar Abbasi, Madineh Akram Abbasian, Mohammadreza Abbastabar, Hedayat Abdelmasseh, Michael Abdollahi, Mohammad Abdollahi, Mozhan Abdollahifar, Mohammad-Amin Abd-Rabu, Rami Abdulah, Deldar Morad Abdullahi, Auwal Abedi, Aidin Abedi, Vida Zuniga, Roberto Ariel Abeldano Abidi, Hassan Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Aboyans, Victor Abrha, Woldu Aberhe Abualhasan, Ahmed Abu-Gharbieh, Eman Aburuz, Salahdein Adamu, Lawan Hassan Addo, Isaac Yeboah Adebayo, Oladimeji M. Adekanmbi, Victor Adekiya, Tayo Alex Adikusuma, Wirawan Adnani, Qorinah Estiningtyas Sakilah Adra, Saryia Afework, Tsion Afolabi, Aanuoluwapo Adeyimika Afraz, Ali Afzal, Saira Aghamiri, Shahin Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmad, Sajjad Ahmadzade, Amir Mahmoud Ahmed, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Jivan Qasim Ahmed, Luai A. Ahmed, Muktar Beshir Ahmed, Syed Anees Ajami, Marjan Aji, Budi Ajumobi, Olufemi Akade, Seyed Esma'il Akbari, Morteza Akbarialiabad, Hossein Akhlaghi, Shiva Akinosoglou, Karolina Akinyemi, Rufus Olusola Akonde, Maxwell Al Hasan, Syed Mahfuz Alahdab, Fares Al-Ahdal, Tareq Mohammed Ali Al-Amer, Rasmieh Mustafa Albashtawy, Mohammed AlBataineh, Mohammad T. Aldawsari, Khalifah A. Alemi, Hediyeh Alemi, Sharifullah Algammal, Abdelazeem M. Al-Gheethi, Adel Ali Saeed Alhalaiqa, Fadwa Alhalaiqa Naji Alhassan, Robert Kaba Ali, Abid Ali, Endale Alemayehu Ali, Liaqat Ali, Mohammed Usman Ali, Musa Mohammed Ali, Rafat Ali, Shahid Ali, Syed Shujait Shujait Ali, Zahid Alif, Sheikh Mohammad Alimohamadi, Yousef Aliyi, Ahmednur Adem Aljofan, Mohamad Aljunid, Syed Mohamed Alladi, Suvarna Almazan, Joseph Uy Almustanyir, Sami Al-Omari, Basem Alqahtani, Jaber S. Alqasmi, Ibrahim Alqutaibi, Ahmed Yaseen Salman, Rustam Al-Shahi Altaany, Zaid Al-Taw Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98105 USA Univ Washington Sch Med Dept Hlth Metr Sci Seattle WA USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Dept Family Med Seattle WA USA Univ Washington Dept Neurol Surg Seattle WA USA Univ Washington Div Pediat Hematol Oncol Seattle WA USA Univ Washington Dept Epidemiol Seattle WA USA Univ Washington Dept Neurol Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Hlth Syst & Populat Hlth Seattle WA USA WHO Dept Mental Hlth & Substance Use Geneva Switzerland WHO Dept Data & Analyt Geneva Switzerland Univ Southern Calif Ctr Econ & Social Res Los Angeles CA USA Univ Southern Calif Dept Neurosurg Los Angeles CA USA Univ Southern Calif Keck Sch Med Los Angeles CA USA Univ Southern Calif Dept Radiol Los Angeles CA USA Aleta Wondo Hosp Dept Clin Governance & Qual Improvement Aleta Wondo Ethiopia Shanghai Jiao Tong Univ Mental Hlth Ctr Shanghai Peoples R China Tabriz Univ Med Sci Infect & Trop Res Ctr Tabriz Iran Tabriz Univ Med Sci Dept Radiol Tabriz Iran Tabriz Univ Med Sci Sch Nursing & Midwifery Tabriz Iran Tabriz Univ Med Sci Dept Immunol Tabriz Iran Tabriz Univ Med Sci Dept Community Med Tabriz Iran Tabriz Univ Med Sci Dept Mental Hlth & Psychiat Nursing Tabriz Iran Tabriz Univ Med Sci Drug Appl Res Ctr Tabriz Iran Harvard Univ Dept Orthoped Surg Boston MA USA Harvard Univ Dept Pediat Boston MA USA Harvard Univ TH Chan Sch Publ Hlth Boston MA USA Harvard Univ Ctr Primary Care Boston MA USA Harvard Univ Harvard Business Sch Boston MA USA Harvard Univ Div Cardiovasc Med Boston MA USA Harvard Univ Div Cardiol Boston MA USA Harvard Univ Dept Hlth Policy & Oral Epidemiol Boston MA USA Harvard Univ Dept Phys Med & Rehabil Boston MA USA Shahid Beheshti Univ Med Sci Dept Orthopaed Surg Tehran I

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous sys

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Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021

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LANCET 2024年第10440期403卷 2204-2256页

作者： Vollset, Stein Emil Ababneh, Hazim S. Abate, Yohannes Habtegiorgis Abbafati, Cristiana Abbasgholizadeh, Rouzbeh Abbasian, Mohammadreza Abbastabar, Hedayat Abd Al Magied, Abdallah H. A. Abd ElHafeez, Samar Abdelkader, Atef Abdelmasseh, Michael Abd-Elsalam, Sherief Abdi, Parsa Abdollahi, Mohammad Abdoun, Meriem Abdullahi, Auwal Abebe, Mesfin Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Abouzid, Mohamed Aboye, Girma Beressa Abreu, Lucas Guimaraes Absalan, Abdorrahim Abualruz, Hasan Abubakar, Bilyaminu Abukhadijah, Hana Jihad Jihad Addolorato, Giovanni Adekanmbi, Victor Adetunji, Charles Oluwaseun Adetunji, Juliana Bunmi Adeyeoluwa, Temitayo Esther Adha, Rishan Adhikary, Ripon Kumar Adnani, Qorinah Estiningtyas Sakilah Adzigbli, Leticia Akua Afrashteh, Fatemeh Afzal, Muhammad Sohail Afzal, Saira Agbozo, Faith Agodi, Antonella Agrawal, Anurag Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahlstrom, Austin J. Ahmad, Aqeel Ahmad, Firdos Ahmad, Muayyad M. Ahmad, Sajjad Ahmad, Shahzaib Ahmed, Anisuddin Ahmed, Ayman Ahmed, Haroon Ahmed, Safoora Ahmed, Syed Anees Akinosoglou, Karolina Akkaif, Mohammed Ahmed Akrami, Ashley E. Akter, Ema Al Awaidy, Salah Al Hasan, Syed Mahfuz Al Mosa, Amjad S. Al Ta'ani, Omar Al Zaabi, Omar Ali Mohammed Alahdab, Fares Alajlani, Muaaz M. Al-Ajlouni, Yazan Alalalmeh, Samer O. Al-Aly, Ziyad Alam, Khurshid Alam, Noore Alam, Tahiya Alam, Zufishan Al-Amer, Rasmieh Mustafa Alanezi, Fahad Mashhour Alanzi, Turki M. Albakri, Almaza Aldhaleei, Wafa A. Aldridge, Robert W. Alemohammad, Seyedeh Yasaman Alemu, Yihun Mulugeta Al-Gheethi, Adel Ali Saeed Al-Hanawi, Mohammed Khaled Ali, Abid Ali, Amjad Ali, Iman Ali, Mohammed Usman Ali, Rafat Ali, Syed Shujait Shujait Ali, Victor Ekoche Ali, Waad Al-Ibraheem, Akram Alicandro, Gianfranco Alif, Sheikh Mohammad Aljunid, Syed Mohamed Alla, Francois Almazan, Joseph Uy Al-Mekhlafi, Hesham M. Alqutaibi, Ahmed Yaseen Alrawashdeh, Ahmad Alrousan, Sahel Majed Al-Sabah, Salman Khalifah Alsabri, Mohammed A. Altaany, Zaid Al-Tammemi, Ala'a B. Al-Tawfiq, Jaffa Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98195 USA Univ Washington Sch Med Dept Hlth Metr Sci Seattle WA USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Sch Med Seattle WA USA Univ Washington Div Pediat Hematol Oncol Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Henry M Jackson Sch Int Studies Seattle WA USA Norwegian Inst Publ Hlth GBD Collaborating Unit Bergen Norway Norwegian Inst Publ Hlth Dept Dis Burden Bergen Norway Massachusetts Gen Hosp Dept Radiat Oncol Boston MA USA Massachusetts Gen Hosp Dept Orthopaed Surg Boston MA USA Massachusetts Gen Hosp Dept Radiol Boston MA USA Massachusetts Gen Hosp Div Cardiol Boston MA USA Massachusetts Gen Hosp Cardiovasc Res Ctr Boston MA USA Aleta Wondo Hosp Dept Clin Governance & Qual Improvement Aleta Wondo Ethiopia Univ Roma La Sapienza Dept Jurid & Econ Studies Rome Italy Univ Roma La Sapienza Dept Publ Hlth & Infect Dis Rome Italy Univ Calif Los Angeles Doheny Eye Inst Los Angeles CA USA Univ Calif Los Angeles Radiol Dept Los Angeles CA USA Harvard Univ Dept Orthoped Surg Boston MA USA Harvard Univ TH Chan Sch Publ Hlth Boston MA USA Harvard Univ Ctr Primary Care Boston MA USA Harvard Univ Harvard Business Sch Boston MA USA Harvard Univ Div Cardiovasc Med Boston MA USA Harvard Univ Dept Hlth Policy & Oral Epidemiol Boston MA USA Harvard Univ Dept Global Hlth & Social Med Boston MA USA Harvard Univ Beth Israel Deaconess Med Ctr Boston MA USA Shahid Beheshti Univ Med Sci Dept Orthopaed Surg Tehran Iran Shahid Beheshti Univ Med Sci Urol Dept Tehran Iran Shahid Beheshti Univ Med Sci Internal Med Dept SBMU Tehran Iran Shahid Beheshti Univ Med Sci Sch Med Tehran Iran Shahid Beheshti Univ Med Sci Psychiat Nursing & Management Dept Tehran Iran Shahid Beheshti Univ Med Sci Dept Med Genet Tehran

Background Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods Using forecasts of major drivers of health such as the Socio-demographic Index (SDI;a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects mode

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Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021

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LANCET 2024年第10440期403卷 2162-2203页

作者： Brauer, Michael Roth, Gregory A. Aravkin, Aleksandr Y. Zheng, Peng Abate, Kalkidan Hassen Abate, Yohannes Habtegiorgis Abbafati, Cristiana Abbasgholizadeh, Rouzbeh Abbasi, Madineh Akram Abbasian, Mohammadreza Abbasifard, Mitra Abbasi-Kangevari, Mohsen ElHafeez, Samar Abd Abd-Elsalam, Sherief Abdi, Parsa Abdollahi, Mohammad Abdoun, Meriem Abdulah, Deldar Morad Abdullahi, Auwal Abebe, Mesfin Abedi, Aidin Abedi, Armita Abegaz, Tadesse M. Zuniga, Roberto Ariel Abeldano Abiodun, Olumide Abiso, Temesgen Lera Aboagye, Richard Gyan Abolhassani, Hassan Abouzid, Mohamed Aboye, Girma Beressa Abreu, Lucas Guimaraes Abualruz, Hasan Abubakar, Bilyaminu Abu-Gharbieh, Eman Abukhadijah, Hana Jihad Jihad Aburuz, Salahdein Abu-Zaid, Ahmed Adane, Mesafint Molla Addo, Isaac Yeboah Addolorato, Giovanni Adedoyin, Rufus Adesoji Adekanmbi, Victor Aden, Bashir Adetunji, Juliana Bunmi Adeyeoluwa, Temitayo Esther Adha, Rishan Adibi, Amin Estiningtyas, Qorinah Adnani, Sakilah Adzigbli, Leticia Akua Afolabi, Aanuoluwapo Adeyimika Afolabi, Rotimi Felix Afshin, Ashkan Afyouni, Shadi Afzal, Muhammad Sohail Afzal, Saira Agampodi, Suneth Buddhika Agbozo, Faith Aghamiri, Shahin Agodi, Antonella Agrawal, Anurag Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Noah Ahmad, Shahzaib Ahmad, Tauseef Ahmed, Ali Ahmed, Anisuddin Ahmed, Ayman Ahmed, Luai A. Ahmed, Muktar Beshir Ahmed, Safoora Ahmed, Syed Anees Ajami, Marjan Akalu, Gizachew Taddesse Akara, Essona Matatom Akbarialiabad, Hossein Akhlaghi, Shiva Akinosoglou, Karolina Akinyemiju, Tomi Akkaif, Mohammed Ahmed Akkala, Sreelatha Akombi-Inyang, Blessing Al Awaidy, Salah Al Hasan, Syed Mahfuz Alahdab, Fares AL-Ahdal, Tareq Mohammed Ali Alalalmeh, Samer O. Alalwan, Tariq A. Al-Aly, Ziyad Alam, Khurshid Alam, Nazmul Alanezi, Fahad Mashhour Alanzi, Turki M. Albakri, Almaza AlBataineh, Mohammad T. Aldhaleei, Wafa A. Aldridge, Robert W. Alemayohu, Mulubirhan Assefa Alemu, Yihun Mulugeta Al-Fatly, Bassam Al-Gheethi, Adel Ali Saeed Al-Habbal, Khairat Alhabib, Kh Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98195 USA Univ Washington Div Cardiol Seattle WA USA Univ Washington Sch Med Dept Hlth Metr Sci Seattle WA USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Univ Washington Div Pediat Hematol Oncol Seattle WA USA Univ Washington Dept Neurol Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Henry M Jackson Sch Int Studies Seattle WA USA Univ Washington Dept Pharm Seattle WA USA Univ Washington Dept Med Seattle WA USA Univ British Columbia Sch Populat & Publ Hlth Vancouver BC Canada Univ British Columbia Dept Pharmaceut Sci Vancouver BC Canada Univ British Columbia Sch Nursing Vancouver BC Canada Jimma Univ Dept Nutr & Dietet Jimma Ethiopia Jimma Univ Dept Epidemiol Jimma Ethiopia Jimma Univ Dept Publ Hlth Jimma Ethiopia Jimma Univ Dept Surg Jimma Ethiopia Jimma Univ Inst Hlth Sci Jimma Ethiopia Jimma Univ Dept Psychiat Jimma Ethiopia Aleta Wondo Hosp Dept Clin Governance & Qual Improvement Aleta Wondo Ethiopia Univ Roma La Sapienza Dept Jurid & Econ Studies Rome Italy Sapienza Univ Dept Publ Hlth & Infect Dis Rome Italy Univ Calif Los Angeles Doheny Eye Inst Los Angeles CA USA Univ Calif Los Angeles David Geffen Sch Med Los Angeles CA USA Tabriz Univ Med Sci Infect & Trop Res Ctr Tabriz Iran Tabriz Univ Med Sci Res Ctr Psychiat & Behav Sci Tabriz Iran Tabriz Univ Med Sci Dept Radiol Tabriz Iran Tabriz Univ Med Sci Dept Hlth Policy & Management Tabriz Iran Tabriz Univ Med Sci Sch Nursing & Midwifery Tabriz Iran Tabriz Univ Med Sci Dept Immunol Tabriz Iran Tabriz Univ Med Sci Fac Nursing & Midwifery Tabriz Iran Tabriz Univ Med Sci Neurosci Res Ctr NSRC Tabriz Iran Tabriz Univ Med Sci Student Res Comm Tabriz Iran Tabriz Univ Med Sci Drug Appl Res Ctr Tabriz Iran Harvard Univ Dept Orthoped Surg Boston MA USA

Background Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF;ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk fac

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Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

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LANCET 2024年第10440期403卷 2057-2099页

作者： Bhattacharjee, Natalia V. Schumacher, Austin E. Aali, Amirali Abate, Yohannes Habtegiorgis Abbasgholizadeh, Rouzbeh Abbasian, Mohammadreza Abbasi-Kangevari, Mohsen Abbastabar, Hedayat Abd ElHafeez, Samar Abd-Elsalam, Sherief Abdollahi, Mohammad Abdollahifar, Mohammad-Amin Abdoun, Meriem Abdullahi, Auwal Abebe, Mesfin Abebe, Samrawit Shawel Abiodun, Olumide Abolhassani, Hassan Abolmaali, Meysam Abouzid, Mohamed Aboye, Girma Beressa Abreu, Lucas Guimaraes Abrha, Woldu Aberhe Abrigo, Michael R. M. Abtahi, Dariush Abualruz, Hasan Abubakar, Bilyaminu Abu-Gharbieh, Eman Abu-Rmeileh, Niveen M. E. Adal, Tadele Girum Girum Adane, Mesafint Molla Adeagbo, Oluwafemi Atanda Adeagbo Adedoyin, Rufus Adesoji Adekanmbi, Victor Aden, Bashir Adepoju, Abiola Victor Adetokunboh, Olatunji O. Adetunji, Juliana Bunmi Adeyinka, Daniel Adedayo Adeyomoye, Olorunsola Israel Adnani, Qorinah Estiningtyas Sakilah Adra, Saryia Afolabi, Rotimi Felix Afyouni, Shadi Afzal, Muhammad Sohail Afzal, Saira Aghamiri, Shahin Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahlstrom, Austin J. Ahmad, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Muayyad M. Ahmad, Sajjad Ahmad, Tauseef Ahmed, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A. Ahmed, Meqdad Saleh Ahmed, Syed Anees Ajami, Marjan Aji, Budi Akalu, Gizachew Taddesse Akbarialiabad, Hossein Akinyemi, Rufus Olusola Akkaif, Mohammed Ahmed Akkala, Sreelatha Al Hamad, Hanadi Al Hasan, Syed Mahfuz Al Qadire, Mohammad Al-Ahdal, Tareq Mohammed Ali Alalalmeh, Samer O. Alalwan, Tariq A. Al-Aly, Ziyad Alam, Khurshid Al-Amer, Rasmieh Mustafa Alanezi, Fahad Mashhour Alanzi, Turki M. Albakri, Almaza Albashtawy, Mohammed AlBataineh, Mohammad T. Alemi, Hediyeh Alemi, Sharifullah Alemu, Yihun Mulugeta Al-Eyadhy, Ayman Al-Gheethi, Adel Ali Saeed Alhabib, Khalid F. Alhajri, Noora Alhalaiqa, Fadwa Naji Alhalaiqa Alhassan, Robert Kaba Ali, Abid Ali, Beriwan Abdulqadir Ali, Liaqat Ali, Mohammed Usman Ali, Rafat Ali, Syed Shujait Shujait Alif, Sheikh Mohammad Aligol, Mohammad Alijanzadeh, Mehran Aljasir, Mohamma Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98195 USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Dept Hlth Metr Sci Sch Med Seattle WA USA Univ Washington Dept Internal Med Seattle WA USA Univ Washington Dept Cardiol Seattle WA USA Univ Washington Dept Family Med Seattle WA USA Univ Washington Dept Neurol Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Mashhad Univ Med Sci Fac Med Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dent Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Orthodont Dept Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Clin Res Dev Unit Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Metab Syndrome Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Int UNESCO Ctr Hlth Related Basic Sci & Human Nut Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Appl Biomed Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Biotechnol Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Med Genet Mashhad Razavi Khorasan Iran Aleta Wondo Hosp Dept Clin Governance & Qual Improvement Aleta Wondo Ethiopia Univ Calif Los Angeles Doheny Eye Inst Pasadena CA USA Harvard Univ Dept Orthoped Surg Boston MA USA Harvard Univ Dept Pediat Boston MA USA Harvard Univ TH Chan Sch Publ Hlth Boston MA USA Harvard Univ Ctr Primary Care Boston MA USA Harvard Univ Harvard Business Sch Boston MA USA Harvard Univ Div Cardiovasc Med Boston MA USA Harvard Univ Dept Neurol Surg Brigham & Womens Hosp Boston MA USA Harvard Univ Maternal Fetal Care Ctr Boston MA USA Harvard Univ Dept Ophthalmol Boston MA USA Harvard Univ Dept Hlth Policy & Management Boston MA USA Harvard Univ Radiol & Data Sci Dept Boston MA USA Harvard Univ Dept Hlth Policy & Oral Epidemiol Boston MA USA Harvard Univ Dept Global Hlth & Social Med Boston MA US

Background Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50;the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in hab

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Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

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LANCET 2024年第10440期403卷 1989-2056页

作者： Schumacher, Austin E. Kyu, Hmwe Hmwe Aali, Amirali Abbafati, Cristiana Abbas, Jaffar Abbasgholizadeh, Rouzbeh Abbasi, Madineh Akram Abbasian, Mohammadreza Abd ElHafeez, Samar Abdelmasseh, Michael Abd-Elsalam, Sherief Abdelwahab, Ahmed Abdollahi, Mohammad Abdoun, Meriem Abdullahi, Auwal Abdurehman, Ame Mehadi Abebe, Mesfin Abedi, Aidin Abedi, Armita Abegaz, Tadesse M. Zuniga, Roberto Ariel Abeldano Abhilash, E. S. Abiodun, Olugbenga Olusola Aboagye, Richard Gyan Abolhassani, Hassan Abouzid, Mohamed Abreu, Lucas Guimaraes Abrha, Woldu Aberhe Abrigo, Michael R. M. Abtahi, Dariush Abu Rumeileh, Samir Abu-Rmeileh, Niveen M. E. Aburuz, Salahdein Abu-Zaid, Ahmed Acuna, Juan Manuel Adair, Tim Addo, Isaac Yeboah Adebayo, Oladimeji M. Adegboye, Oyelola A. Adekanmbi, Victor Aden, Bashir Adepoju, Abiola Victor Adetunji, Charles Oluwaseun Adeyeoluwa, Temitayo Esther Adeyomoye, Olorunsola Israel Adha, Rishan Adibi, Amin Adikusuma, Wirawan Adnani, Qorinah Estiningtyas Sakilah Adra, Saryia Afework, Abel Afolabi, Aanuoluwapo Adeyimika Afraz, Ali Afyouni, Shadi Afzal, Saira Agasthi, Pradyumna Aghamiri, Shahin Agodi, Antonella Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Muayyad M. Ahmad, Tauseef Ahmadi, Keivan Ahmadzade, Amir Mahmoud Ahmadzade, Mohadese Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A. Ahmed, Muktar Beshir Ahmed, Syed Anees Ajami, Marjan Aji, Budi Ajumobi, Olufemi Akalu, Gizachew Taddesse Akara, Essona Matatom Akinosoglou, Karolina Akkala, Sreelatha Akyirem, Samuel Al Hamad, Hanadi Al Hasan, Syed Mahfuz Al Homsi, Ammar Al Qadire, Mohammad Ala, Moein Aladelusi, Timothy Olukunle AL-Ahdal, Tareq Mohammed Ali Alalalmeh, Samer O. Al-Aly, Ziyad Alam, Khurshid Alam, Manjurul Alam, Zufishan Al-Amer, Rasmieh Mustafa Alanezi, Fahad Mashhour Alanzi, Turki M. Albashtawy, Mohammed AlBataineh, Mohammad T. Aldridge, Robert W. Alemi, Sharifullah Al-Eyadhy, Ayman Al-Gheethi, Adel Ali Saeed Alhabib, Khalid F. Alhalaiqa, Fadwa Alhalaiqa Naji Al-Hanawi, Mohammed Khaled Ali, Abid Ali, Akhtar Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98195 USA Univ Washington Dept Hlth Metr Sci Sch Med Seattle WA USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Sch Med Seattle WA USA Univ Washington Dept Internal Med Seattle WA USA Univ Washington Dept Cardiol Seattle WA USA Univ Washington Dept Family Med Seattle WA USA Univ Washington Div Pediat Hematoloncol Seattle WA USA Univ Washington Dept Neurol Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Foster Sch Business Seattle WA USA Univ Washington Dept Biostat Seattle WA USA Univ Washington Sch Social Work Seattle WA USA Univ Washington Div Allergy & Infect Dis Seattle WA USA Mashhad Univ Med Sci Fac Med Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Neurosci Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Emam Reza Hosp Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Clin Res Dev Unit Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Metab Syndrome Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Int UNESCO Ctr Hlth Related Basic Sci & Human Nut Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Med Genet Mashhad Razavi Khorasan Iran Univ Roma La Sapienza Dept Jurid & Econ Studies Rome Italy Univ Roma La Sapienza Dept Publ Hlth & Infect Dis Rome Italy Shanghai Jiao Tong Univ Antai Coll Econ Shanghai Peoples R China Shanghai Jiao Tong Univ Shanghai Mental Hlth Ctr Shanghai Peoples R China Univ Calif Los Angeles Doheny Eye Inst Los Angeles CA USA Univ Calif Los Angeles Dept Ophthalmol Los Angeles CA USA Univ Calif Los Angeles Ctr Social Med Los Angeles CA USA Tabriz Univ Med Sci Infect & Trop Res Ctr Tabriz Iran Tabriz Univ Med Sci TB & Lung Dis Res Ctr Tabriz Iran Tabriz Univ Med Sci Dept Radiol Tabriz Iran Tabriz Univ Med Sci Dept Hlth Policy & Management Tabr

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration;the effects of the HIV epidemic;and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenat

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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021

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LANCET 2024年第10440期403卷 2100-2132页

作者： Naghavi, Mohsen Ong, Kanyin Liane Aali, Amirali Ababneh, Hazim S. Abate, Yohannes Habtegiorgis Abbafati, Cristiana Abbasgholizadeh, Rouzbeh Abbasian, Mohammadreza Abbasi-Kangevari, Mohsen Abbastabar, Hedayat Abd ElHafeez, Samar Abdelmasseh, Michael Abd-Elsalam, Sherief Abdelwahab, Ahmed Abdollahi, Mohammad Abdollahifar, Mohammad-Amin Abdoun, Meriem Abdulah, Deldar Morad Abdullahi, Auwal Abebe, Mesfin Abebe, Samrawit Shawel Abedi, Aidin Abegaz, Kedir Hussein Abhilash, E. S. Abidi, Hassan Abiodun, Olumide Aboagye, Richard Gyan Abolhassani, Hassan Abolmaali, Meysam Abouzid, Mohamed Aboye, Girma Beressa Abreu, Lucas Guimaraes Abrha, Woldu Aberhe Abtahi, Dariush Abu Rumeileh, Samir Abualruz, Hasan Abubakar, Bilyaminu Abu-Gharbieh, Eman Abu-Rmeileh, Niveen M. E. Aburuz, Salahdein Abu-Zaid, Ahmed Accrombessi, Manfred Mario Kokou Adal, Tadele Girum Adamu, Abdu A. Addo, Isaac Yeboah Addolorato, Giovanni Adebiyi, Akindele Olupelumi Adekanmbi, Victor Adepoju, Abiola Victor Adetunji, Charles Oluwaseun Adetunji, Juliana Bunmi Adeyeoluwa, Temitayo Esther Adeyinka, Daniel Adedayo Adeyomoye, Olorunsola Israel Admass, Biruk Adie Adie Adnani, Qorinah Estiningtyas Sakilah Adra, Saryia Afolabi, Aanuoluwapo Adeyimika Afzal, Muhammad Sohail Afzal, Saira Agampodi, Suneth Buddhika Agasthi, Pradyumna Aggarwal, Manik Aghamiri, Shahin Agide, Feleke Doyore Agodi, Antonella Agrawal, Anurag Agyemang-Duah, Williams Ahinkorah, Bright Opoku Ahmad, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Muayyad M. Ahmad, Sajjad Ahmad, Shahzaib Ahmad, Tauseef Ahmadi, Keivan Ahmadzade, Amir Mahmoud Ahmed, Ali Ahmed, Ayman Ahmed, Haroon Ahmed, Luai A. Ahmed, Mehrunnisha Sharif Ahmed, Meqdad Saleh Ahmed, Muktar Beshir Ahmed, Syed Anees Ajami, Marjan Aji, Budi Akara, Essona Matatom Akbarialiabad, Hossein Akinosoglou, Karolina Akinyemiju, Tomi Akkaif, Mohammed Ahmed Akyirem, Samuel Al Hamad, Hanadi Al Hasan, Syed Mahfuz Alahdab, Fares Alalalmeh, Samer O. Alalwan, Tariq A. Al-Aly, Ziyad Alam, Khurshid Alam, Manjurul Alam, Noore Al-Amer, Rasmieh Mustafa Alanezi, Fahad Univ Washington Inst Hlth Metr & Evaluat Seattle WA 98195 USA Univ Washington Sch Med Dept Hlth Metr Sci Seattle WA USA Univ Washington Dept Appl Math Seattle WA USA Univ Washington Dept Global Hlth Seattle WA USA Univ Washington Sch Med Seattle WA USA Univ Washington Dept Internal Med Seattle WA USA Univ Washington Dept Cardiol Seattle WA USA Univ Washington Dept Hlth Syst & Populat Hlth Seattle WA USA Univ Washington Dept Pediat Seattle WA USA Univ Washington Dept Family Med Seattle WA USA Univ Washington Dept Neurol Seattle WA USA Univ Washington Dept Anesthesiol & Pain Med Seattle WA USA Univ Washington Div Plast & Reconstruct Surg Seattle WA USA Univ Washington Henry M Jackson Sch Int Studies Seattle WA USA Univ Washington Div Cardiol Seattle WA USA Mashhad Univ Med Sci Fac Med Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Neurosci Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dent Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Orthodont Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Clin Res Dev Unit Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Appl Biomed Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Biotechnol Res Ctr Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Med Informat Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Clin Res Dev Unit Mashhad Razavi Khorasan Iran Mashhad Univ Med Sci Dept Med Genet Mashhad Razavi Khorasan Iran Massachusetts Gen Hosp Radiat Oncol Boston MA USA Massachusetts Gen Hosp Dept Orthopaed Surg Boston MA USA Massachusetts Gen Hosp Div Cardiol Boston MA USA Massachusetts Gen Hosp Dept Radiol Boston MA USA Massachusetts Gen Hosp Cardiovasc Res Ctr Boston MA USA Aleta Wondo Hosp Dept Clin Governance & Qual Improvement Aleta Wondo Ethiopia Univ Roma La Sapienza Dept Jurid & Econ Studies Rome Italy Univ Roma La Sapienza Dept Publ Hlth & Infect Dis Rome Italy Univ Calif Los Angeles Doheny Eye Inst Los Angeles CA

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2.5th and 97.5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location

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