Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023

Background: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality e...

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Autores: Naghavi, Mohsen, Kyu, Hmwe Hmwe, A., Bhoomadevi, Aalipour, Mohammad Amin, Aalruz, Hasan, Ababneh, Hazim S., Abafita, Bedru Jemal, Abaraogu, Ukachukwu Okoroafor, Abbafati, Cristiana, Abbasi, Madineh, Abbaspour, Faezeh, Abbastabar, Hedayat, Abd Al Magied, Abdallah H. A., Abd ElHafeez, Samar, Abdalla, Ashraf Nabiel, Abdalla, Mohammed Altigani, Abdallah, Emad M., Abdeeq, Barkhad Aden, Abdel Razeq, Nadin M., Abdelgalil, Ahmed Abdelrahman, Abdel-Hameed, Reda, Abdelmasseh, Michael, Abdelnabi, Mahmoud, Abdel-Rahman, Wael M., Abdous, Arman, Abdrabou, Mostafa M., Aziz, Jeza Muhamad Abdul, Abdulah, Deldar Morad, Abdullahi, Auwal, Abdul-Rahman, Toufik, Getahun, Habtamu Abebe, Abedi, Aidin, Abedi, Armita, Abedi, Parisa, Abejew, Asrat Agalu, Abeldaño Zúñiga, Roberto Ariel, Abid, Shehab Uddin Al, Abidi, Syed Hani, Abie, Alemwork, Abiodun, Olugbenga Olusola, Aboagye, Richard Gyan, Abohashem, Shady, Abolhassani, Hassan, Abonie, Ulric Sena, Abourashed, Nagah M., Abouzid, Mohamed, Abramov, Dmitry, Abreu, Lucas Guimarães, Abtahi, Dariush, Abu Farha, Rana Kamal, Abuadas, Fuad Hamdi A., Abubakar, Aminu Kende, Abu-Elala, Nermeen, Abu-Gharbieh, Eman, Abuhammad, Sawsan, Abuhelwa, Ahmad Yousef, Abukhadijah, Hana J., Abu-Rmeileh, Niveen M.E., Aburuz, Salahdein, Abushanab, Dina, Accrombessi, Manfred Mario Kokou, Acharya, Anirudh Balakrishna, Acharya, Apurba, Adal, Ousman, Adams, Lisa Christine, Adamu, Abdu Abdullahi, Addo, Isaac Yeboah, Adeagbo, Oluwafemi Atanda, Adebisi, Tajudeen Adesanmi, Adedeji, Isaac Akinkunmi, Adedokun, Kamoru Ademola, Adegbile, Oluwatobi E., Adegoke, Nurudeen A., Adeleke, Olumide Thomas, Adema, Bulcha Guye, Aden, Bashir, Adesina, Isaac Ayodeji, Adesina, Miracle Ayomikun, Adetunji, Juliana Bunmi, Adewuyi, Habeeb Omoponle, Adeyeoluwa, Temitayo Esther, Adhana, Mache Tsadik, Adhikary, Ripon Kumar, Adiga, Usha, Adl Parvar, Tanin, Adnan, Mohd, Adnani, Qorinah Estiningtyas Sakilah, Adoma, Prince Owusu, Adzigbli, Leticia Akua, Adzrago, David, Affinito, Giuseppina, Afifi, Ahmed M., Afoakwah, Clifford, Afolabi, Aanuoluwapo Adeyimika, Afolabi, Rotimi Felix, Afrăsânie, Vlad-Adrian, Afzal, Saira, Agafari, Gizachew Beykaso, Agampodi, Suneth Buddhika, Agampodi, Thilini Chanchala, Aggarwal, Navidha, Aghaalikhani, Mahdi, Aghajanian, Sepehr, Aghamir, Seyed Mohammad Kazem, Agide, Feleke Doyore, Agostinis-Sobrinho, César, Agrawal, Anurag, Agyemang-Duah, Williams, Ahadi, Mahsa, Ahinkorah, Bright Opoku, Ahmad, Aqeel, Ahmad, Danish, Ahmad, Faisal, Ahmad, Ijaz, Ahmad, Khabir, Ahmad, Khurshid, Ahmad, Sajjad, Ahmad, Tauseef, Ahmad, Waqas, Ahmadi, Negar Sadat, Ahmed, Ali, Ahmed, Ayman, Ahmed, Gasha Salih, Ahmed, Haroon, Ahmed, Junaid, Ahmed, Luai A., Ahmed, M.D. Faisal, Ahmed, Mehrunnisha Sharif, Ahmed, Meqdad Saleh, Ahmed, Muktar Beshir, Ahmed, Mushood, Ahmed, Shabbir, Ahmed, Sindew Mahmud, Ahmed, Syed Anees, Aimagambetova, Gulzhanat, Ajami, Marjan, Aji, Budi, Akbarialiabad, Hossein, Akbarifard, Saeid, Akeju, Oluwasefunmi, Akhigbe, Roland Eghoghosoa, Akhmedullin, Ruslan, Akinkuotu, Olufemi Ambrose, Akkaif, Mohammed Ahmed, Akosile, Wole, Akrami, Ashley E., Akyea, Ralph Kwame, Al Amiry, Alaa, Al Awaidy, Salah, Al Hasan, Syed Mahfuz, Al Homsi, Ammar, Al Nawayseh, Mohammad Khaled, Al Omari, Omar, Al Ta'ani, Zain, Al Thaher, Yazan, Al 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Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2025
País:España
Recursos:Universidad San Jorge (USJ)
Repositório:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:dnet:academicae__::da8c22837a51f5e75898687e98ab288d
Acesso em linha:https://hdl.handle.net/2454/56917
Access Level:Acceso aberto
Palavra-chave:GBD 2023
COVID-19 pandemic
Causes of death
Systematic analysis
Descrição
Resumo:Background: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. Methods: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. Findings: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6–47·0) in 1990 to 63·4 years (63·1–63·7) in 2023. For males, mean age increased from 45·4 years (45·1–45·7) to 61·2 years (60·7–61·6), and for females it increased from 48·5 years (48·1–48·8) to 65·9 years (65·5–66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9–81·0) and for males 74·8 years (74·8–74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5–38·4) for females and 35·6 years (35·2–35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value.