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      The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

      research-article
      1 , 60 , 1 , 1 , 1 , 1 , 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 1 , 16 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ,   45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 57 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 1 , 1
      Injury Prevention
      BMJ Publishing Group

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          Abstract

          Background

          The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country.

          Methods

          Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures.

          Results

          In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries.

          Conclusions

          Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

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          Most cited references25

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          Quantifying the burden of disease: the technical basis for disability-adjusted life years.

          C. Murray (1994)
          Detailed assumptions used in constructing a new indicator of the burden of disease, the disability-adjusted life year (DALY), are presented. Four key social choices in any indicator of the burden of disease are carefully reviewed. First, the advantages and disadvantages of various methods of calculating the duration of life lost due to a death at each age are discussed. DALYs use a standard expected-life lost based on model life-table West Level 26. Second, the value of time lived at different ages is captured in DALYs using an exponential function which reflects the dependence of the young and the elderly on adults. Third, the time lived with a disability is made comparable with the time lost due to premature mortality by defining six classes of disability severity. Assigned to each class is a severity weight between 0 and 1. Finally, a three percent discount rate is used in the calculation of DALYs. The formula for calculating DALYs based on these assumptions is provided.
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            A scandal of invisibility: making everyone count by counting everyone.

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              Civil registration systems and vital statistics: successes and missed opportunities.

              Vital statistics generated through civil registration systems are the major source of continuous monitoring of births and deaths over time. The usefulness of vital statistics depends on their quality. In the second paper in this Series we propose a comprehensive and practical framework for assessment of the quality of vital statistics. With use of routine reports to the UN and cause-of-death data reported to WHO, we review the present situation and past trends of vital statistics in the world and note little improvement in worldwide availability of general vital statistics or cause-of-death statistics. Only a few developing countries have been able to improve their civil registration and vital statistics systems in the past 50 years. International efforts to improve comparability of vital statistics seem to be effective, and there is reasonable progress in collection and publication of data. However, worldwide efforts to improve data have been limited to sporadic and short-term measures. We conclude that countries and developmental partners have not recognised that civil registration systems are a priority.
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                Author and article information

                Journal
                Inj Prev
                Inj. Prev
                injuryprev
                ip
                Injury Prevention
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1353-8047
                1475-5785
                February 2016
                3 December 2015
                : 22
                : 1
                : 3-18
                Affiliations
                [1 ]Institute for Health Metrics and Evaluation , Seattle, Washington, USA
                [2 ]Mekelle University, College of Health Sciences, School of Public Health , Mekelle, Tigray, Ethiopia
                [3 ]Kilte Awlaelo-Health and Demographic Surveillance Site , Mekelle, Tigray, Ethiopia
                [4 ]University of Southern California (USC) Family Medicine Residency Program at California Hospital, a Dignity Health member , Los Angeles, California, USA
                [5 ]Harvard School of Public Health/Harvard Institute for Global Health , Boston, Massachusetts, USA
                [6 ]Kwame Nkrumah University of Science and Technology , Kumasi, Ashanti, Ghana
                [7 ]Charité Universitätsmedizin , Berlin, Germany
                [8 ]Ahmadu Bello University , Zaria, Kaduna State, Nigeria
                [9 ]Ministry of Public Health , Beirut, Lebanon
                [10 ]Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila , Manila, Philippines
                [11 ]Department of Industrial Engineering, Pontificia Universidad Javeriana , Bogota, Cundinamarca, Colombia
                [12 ]Madawalabu University, Ethiopia , Bale Goba, Oromia, Ethiopia
                [13 ]World Bank , Washington DC, USA
                [14 ]Faculty of Health Sciences and Social Work, Trnava University , Trnava, Slovakia
                [15 ]Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health , Madrid, Spain
                [16 ]Public Health Foundation of India , New Delhi, India
                [17 ]Guy's and St. Thomas’ NHS Foundation Trust , London, UK
                [18 ]Griffith University , Brisbane, Queensland, Australia
                [19 ]UNSW Australia , Sydney, Australia
                [20 ]Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago , Dunedin, New Zealand
                [21 ]School of Public Health, College of Health, Massey University , Palmerston North, New Zealand
                [22 ]University of Peradeniya , Peradeniya, Sri Lanka
                [23 ]Sydney School of Public Health, University of Sydney , Sydney, New South Wales, Australia
                [24 ]National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC , Beijing, China
                [25 ]The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences , Moscow, Russia
                [26 ]Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation , Moscow, Russia
                [27 ]Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences , Tehran, Iran
                [28 ]National Institute for Stroke and Applied Neurosciences, AUT University , Auckland, New Zealand
                [29 ]James Cook University , Townsville, Queensland, Australia
                [30 ]Monash University , Melbourne, Victoria, Australia
                [31 ]University of California in San Francisco , San Francisco, California, USA
                [32 ]Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences , Tehran, Iran
                [33 ]Arabian Gulf University , Manama, Bahrain
                [34 ]Fundacion Entornos AC , Cuernavaca, Morelos, Mexico
                [35 ]Central South University, School of Public Health , Changsha, Hunan, China
                [36 ]Virginia Commonwealth University , Richmond, Virginia, USA
                [37 ]Tianjin Centers for Diseases Control and Prevention , Tianjin, China
                [38 ]Jordan University of Science and Technology , Irbid, Jordan
                [39 ]Health Services Academy , Islamabad, Punjab, Pakistan
                [40 ]Expanded Programme on Immunization , Islamabad, Punjab, Pakistan
                [41 ]Oregon Health and Science University , Portland, Oregon, USA
                [42 ]Rajrajeswari Medical College & Hospital , Bangalore, Karnataka, India
                [43 ]EMRiS, Health Services Research, University of Sheffield , Sheffield, South Yorkshire, UK
                [44 ]SUNY-Albany , Rensselaer, New York, USA
                [45 ]Aintree University Hospital NHS Foundation Trust , Liverpool, UK
                [46 ]School of Medicine, University of Liverpool , Liverpool, UK
                [47 ]Swansea University , Swansea, UK
                [48 ]Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University , Trnava, Slovakia
                [49 ]University of York , York, UK
                [50 ]South African Medical Research Council , Cape Town, South Africa
                [51 ]University of Cape Town School of Public Health and Family Medicine , Cape Town, South Africa
                [52 ]Pereleman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania, USA
                [53 ]Children's Hospital of Philadelphia
                [54 ]Addis Ababa University , Addis Ababa, Ethiopia
                [55 ]Pacific Institute for Research & Evaluation , Calverton, Maryland, USA
                [56 ]Curtin University Centre for Population Health , Perth, Western Australia, Australia
                [57 ]University of Washington , Seattle, Washington, USA
                [58 ]Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
                [59 ]National Institute of Psychiatry , Mexico City, Distrito Federal, Mexico
                [60 ]ErasmusMC , Rotterdam, Netherlands
                [61 ]University of British Columbia, School of Population and Public Health , Vancouver, British Columbia, Canada
                [62 ]Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences , Tehran, Iran
                [63 ]Suez Canal University , Ismailia, Egypt
                [64 ]Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Catalonia, Spain
                [65 ]BARC Hospital, HBNI University , Mumbai, Maharashtra, India
                [66 ]Department of Public Health Sciences, Karolinska Institutet , Stockholm, Sweden
                [67 ]University of Alabama at Birmingham , Birmingham, Alabama, USA
                [68 ]An-Najah University , Nablus, Palestine
                [69 ]Tufts Medical Center , Boston, Massachusetts, USA
                [70 ]Norwegian Institute of Public Health , Oslo, Norway
                [71 ]Stavanger University Hospital , Stavanger, Norway
                [72 ]Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation was founded in 1999 by the order of Ministry of Health of Russia , Moscow, Russia
                [73 ]University of Cape Town , Cape Town, Western Province, South Africa
                [74 ]MRC Unit on Anxiety & Stress Disorders , Cape Town, Western Cape, South Africa
                [75 ]University of California , Irvine, USA
                [76 ]University of Illinois at Urbana-Champaign , Champaign, Illinois, USA
                [77 ]IHME , Seattle, Washington, USA
                [78 ]Memorial University, St. John's , Newfoundland, Canada
                [79 ]Auckland University of Technology , Auckland, New Zealand
                [80 ]Johns Hopkins University , Baltimore, Maryland, USA
                [81 ]Hanoi Medical University , Hanoi, Vietnam
                [82 ]UKK Institute for Health Promotion Research , Tampere, Finland
                [83 ]Higher School of Economics , Moscow, Russia
                [84 ]Institute of Public Health, University of Gondar , Gondar, Amhara, Ethiopia
                [85 ]The University of Hong Kong , Hong Kong, China
                [86 ]National Center of Neurology and Psychiatry , Kodaira, Tokyo, Japan
                [87 ]Jackson State University , Jackson, Mississippi, USA
                [88 ]Department of Epidemiology and Biostatistics, School of Public Health , Wuhan, Hubei, China
                [89 ]Global Health Institute, Wuhan University , Wuhan, China
                Author notes
                [Correspondence to ] Dr Juanita A Haagsma, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; jhaagsma@ 123456uw.edu
                Article
                injuryprev-2015-041616
                10.1136/injuryprev-2015-041616
                4752630
                26635210
                ad9ae7af-0d62-4a0f-be18-6fb06bd3e88d
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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