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Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010


Vos, T and Flaxman, AD and Naghavi, M and Lozano, R and Michaud, C and Ezzati, M and Shibuya, K and Salomon, JA and Abdalla, S and Aboyans, V and Abraham, J and Ackerman, I and Aggarwal, R and Ahn, SY and Ali, MK and Alvarado, M and Anderson, HR and Anderson, LM and Andrews, KG and Atkinson, C and Baddour, LM and Bahalim, AN and Barker-Collo, S and Barrero, LH and Bartels, DH and Basanez, MG and Baxter, A and Bell, ML and Benjamin, EJ and Bennett, D and Bernabe, E and Bhalla, K and Bhandari, B and Bikbov, B and Bin Abdulhak, A and Birbeck, G and Black, JA and Blencowe, H and Blore, JD and Blyth, F and Bolliger, I and Bonaventure, A and Boufous, SA and Bourne, R and Boussinesq, M and Braithwaite, T and Brayne, C and Bridgett, L and Brooker, S and Brooks, P and Brugha, TS and Bryan-Hancock, C and Bucello, C and Buchbinder, R and Buckle, GR and Budke, CM and Burch, M and Burney, P and Burstein, R and Calabria, B and Campbell, B and Canter, CE and Carabin, H and Carapetis, J and Carmona, L and Cella, C and Charlson, F and Chen, H and Cheng, AT and Chou, D and Chugh, SS and Coffeng, LE and Colan, SD and Colquhoun, S and Colson, KE and Condon, J and Connor, MD and Cooper, LT and Corriere, M and Cortinovis, M and de Vaccaro, KC and Couser, W and Cowie, BC and Criqui, MH and Cross, M and Dabhadkar, KC and Dahiya, M and Dahodwala, N and Damsere-Derry, J and Danaei, G and Davis, A and De Leo, D and Degenhardt, L and Dellavalle, R and Delossantos, A and Denenberg, J and Derrett, S and Des Jarlais, DC and Dharmaratne, SD and Dherani, M and Diaz-Torne, C and Dolk, H and Dorsey, ER and Driscoll, T and Duber, H and Ebel, B and Edmond, K and Elbaz, A and Ali, SE and Erskine, H and Erwin, PJ and Espindola, P and Ewoigbokhan, SE and Farzadfar, F and Feigin, V and Felson, DT and Ferrari, A and Ferri, CP and Fevre, EM and Finucane, MM and Flaxman, S and Flood, L and Foreman, K and Forouzanfar, MH and Fowkes, FGR and Franklin, R and Fransen, M and Freeman, MK and Gabbe, BJ and Gabriel, SE and Gakidou, E and Ganatra, HA and Garcia, B and Gaspari, F and Gillum, RF and Gmel, G and Gosselin, R and Grainger, R and Groeger, J and Guillemin, F and Gunnell, D and Gupta, R and Haagsma, J and Hagan, H and Halasa, YA and Hall, W and Haring, D and Maria Haro, J and Harrison, JE and Havmoeller, R and Hay, RJ and Higashi, H and Hill, C and Hoen, B and Hoffman, H and Hotez, PJ and Hoy, D and Huang, JJ and Ibeanusi, SE and Jacobsen, KH and James, SL and Jarvis, D and Jasrasaria, R and Jayaraman, S and Johns, N and Jonas, JB and Karthikeyan, G and Kassebaum, N and Kawakami, N and Keren, A and Khoo, JP and King, CH and Knowlton, LM and Kobusingye, O and Koranteng, A and Krishnamurthi, R and Lalloo, R and Laslett, LL and Lathlean, T and Leasher, JL and Lee, YY and Leigh, J and Lim, SS and Limb, E and Lin, JK and Lipnick, M and Lipshultz, SE and Liu, W and Loane, M and Ohno, SL and Lyons, R and Ma, J and Mabweijano, J and MacIntyre, MF and Malekzadeh, R and Mallinger, L and Manivannan, S and Marcenes, W and March, L and Margolis, DJ and Marks, GB and Marks, R and Matsumori, A and Matzopoulos, R and Mayosi, BM and McAnulty, JH and McDermott, MM and McGill, N and McGrath, J and Elena Medina-Mora, M and Meltzer, M and Mensah, GA and Merriman, TR and Meyer, AC and Miglioli, V and Miller, M and Miller, TR and Mitchell, PB and Mocumbi, AO and Moffitt, TE and Mokdad, AA and Monasta, L and Montico, M and Moradi-Lakeh, M and Moran, A and Morawska, L and Mori, R and Murdoch, ME and Mwaniki, MK and Naidoo, K and Nair, MN and Naldi, L and Narayan, KMV and Nelson, PK and Nelson, RG and Nevitt, MC and Newton, CR and Nolte, S and Norman, P and Norman, R and O'Donnell, M and O'Hanlon, S and Olives, C and Omer, SB and Ortblad, K and Osborne, R and Ozgediz, D and Page, A and Pahari, B and Pandian, JD and Rivero, AP and Patten, SB and Pearce, N and Perez Padilla, R and Perez-Ruiz, F and Perico, N and Pesudovs, K and Phillips, D and Phillips, MR and Pierce, K and Pion, S and Polanczyk, GV and Polinder, S and Pope, CA and Popova, S and Porrini, E and Pourmalek, F and Prince, M and Pullan, RL and Ramaiah, KD and Ranganathan, D and Razavi, H and Regan, M and Rehm, JT and Rein, DB and Remuzzi, G and Richardson, K and Rivara, FP and Roberts, T and Robinson, C and De Leon, FR and Ronfani, L and Room, R and Rosenfeld, LC and Rushton, L and Sacco, RL and Saha, S and Sampson, U and Sanchez-Riera, L and Sanman, E and Schwebel, DC and Scott, JG and Segui-Gomez, M and Shahraz, S and Shepard, DS and Shin, H and Shivakoti, R and Singh, D and Singh, GM and Singh, JA and Singleton, J and Sleet, DA and Sliwa, K and Smith, E and Smith, JL and Stapelberg, NJC and Steer, A and Steiner, T and Stolk, WA and Stovner, LJ and Sudfeld, C and Syed, S and Tamburlini, G and Tavakkoli, M and Taylor, HR and Taylor, JA and Taylor, WJ and Thomas, B and Thomson, WM and Thurston, GD and Tleyjeh, IM and Tonelli, M and Towbin, JRA and Truelsen, T and Tsilimbaris, MK and Ubeda, C and Undurraga, EA and van der Werf, MJ and van Os, J and Vavilala, MS and Venketasubramanian, N and Wang, M and Wang, W and Watt, K and Weatherall, DJ and Weinstock, MA and Weintraub, R and Weisskopf, MG and Weissman, MM and White, RA and Whiteford, H and Wiersma, ST and Wilkinson, JD and Williams, HC and Williams, SRM and Witt, E and Wolfe, F and Woolf, AD and Wulf, S and Yeh, PH and Zaidi, AKM and Zheng, ZJ and Zonies, D and Lopez, AD and Murray, CJL, Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010, Lancet, 380, (9859) pp. 2163-2196. ISSN 0140-6736 (2012) [Refereed Article]

Copyright Statement

Copyright 2012 Elsevier Limited.

DOI: doi:10.1016/S0140-6736(12)61729-2


Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs).

Methods: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis.

Findings: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient −037). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa.

Interpretation: Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Laslett, LL (Dr Laura Laslett)
ID Code:82882
Year Published:2012
Web of Science® Times Cited:4462
Deposited By:Menzies Institute for Medical Research
Deposited On:2013-02-21
Last Modified:2017-10-03

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