Years of Life Lost due to Premature Mortality in a Province with the Shortest Life Expectancy in Poland

The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost

INTRODUCTION

Premature mortality refers to deaths that occur before the expected age of death in a given population. Years of life lost (YLL) is a standard parameter that is frequently used to quantify some component of an "avoidable" mortality burden.

OBJECTIVE

To identify the studies on premature cardiovascular disease (CVD) mortality and synthesise their findings on YLL based on the regional area, main CVD types, sex, and study time.

METHOD

We conducted a systematic review of published CVD mortality studies that reported YLL as an indicator for premature mortality measurement. A literature search for eligible studies was conducted in five electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The synthesis of YLL was grouped into years of potential life lost (YPLL) and standard expected years of life lost (SEYLL) using descriptive analysis. These subgroups were further divided into WHO (World Health Organization) regions, study time, CVD type, and sex to reduce the effect of heterogeneity between studies.

RESULTS

Forty studies met the inclusion criteria for this review. Of these, 17 studies reported premature CVD mortality using YPLL, and the remaining 23 studies calculated SEYLL. The selected studies represent all WHO regions except for the Eastern Mediterranean. The overall median YPLL and SEYLL rates per 100,000 population were 594.2 and 1357.0, respectively. The YPLL rate and SEYLL rate demonstrated low levels in high-income countries, including Switzerland, Belgium, Spain, Slovenia, the USA, and South Korea, and a high rate in middle-income countries (including Brazil, India, South Africa, and Serbia). Over the past three decades (1990-2022), there has been a slight increase in the YPLL rate and the SEYLL rate for overall CVD and ischemic heart disease but a slight decrease in the SEYLL rate for cerebrovascular disease. The SEYLL rate for overall CVD demonstrated a notable increase in the Western Pacific region, while the European region has experienced a decline and the American region has nearly reached a plateau. In regard to sex, the male showed a higher median YPLL rate and median SEYLL rate than the female, where the rate in males substantially increased after three decades.

CONCLUSION

Estimates from both the YPLL and SEYLL indicators indicate that premature CVD mortality continues to be a major burden for middle-income countries. The pattern of the YLL rate does not appear to have lessened over the past three decades, particularly for men. It is vitally necessary to develop and execute strategies and activities to lessen this mortality gap.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021288415.

Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.

Burden of suicide in Poland in 2012: how could it be measured and how big is it?

OBJECTIVES

The aim of our study was to estimate the health-related and economic burden of suicide in Poland in 2012 and to demonstrate the effects of using different assumptions on the disease burden estimation.

METHODS

Years of life lost (YLL) were calculated by multiplying the number of deaths by the remaining life expectancy. Local expected YLL (LEYLL) and standard expected YLL (SEYLL) were computed using Polish life expectancy tables and WHO standards, respectively. In the base case analysis LEYLL and SEYLL were computed with 3.5 and 0% discount rates, respectively, and no age-weighting. Premature mortality costs were calculated using a human capital approach, with discounting at 5%, and are reported in Polish zloty (PLN) (1 euro = 4.3 PLN). The impact of applying different assumptions on base-case estimates was tested in sensitivity analyses.

RESULTS

The total LEYLLs and SEYLLs due to suicide were 109,338 and 279,425, respectively, with 88% attributable to male deaths. The cost of male premature mortality (2,808,854,532 PLN) was substantially higher than for females (177,852,804 PLN). Discounting and age-weighting have a large effect on the base case estimates of LEYLLs. The greatest impact on the estimates of suicide-related premature mortality costs was due to the value of the discount rate.

CONCLUSIONS

Our findings provide quantitative evidence on the burden of suicide. In our opinion each of the demonstrated methods brings something valuable to the evaluation of the impact of suicide on a given population, but LEYLLs and premature mortality costs estimated according to national guidelines have the potential to be useful for local public health policymakers.

Fifteen-year mortality trends in Poland analysed with the use of standard expected years of life lost, 2000-2014

The aim of the study is an evaluation of years of life lost by inhabitants of Poland according to the most important causes of mortality and identification of trends in the period 2000-2014. The study material included a database which contained information gathered from 5,601,568 death certificates of inhabitants of Poland. In order to calculate years of life lost, the SEYLL_p index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLL_p index (per 10,000 population) in Poland decreased from 2503.4 in 2000 to 2193.2 in 2014 among males (AAPC = -0.8%, p < 0.05) and from 1430.2 in 2000 to 1269.4 in 2014 among females (AAPC = -0.6%, p < 0.05). In 2014, the top 5 causes of years of life lost were: cardiovascular diseases (721.4 per 10,000 males and 475.6 per 10,000 females), malignant tumours (575.5 and 418.3), unintentional injuries (202.2 and 46.8), intentional injuries (114.6 and 16.3) and digestive diseases (120.2 and 58.3). Due to negative trends, there is a need to implement preventative measures, aimed at reducing mortality caused by respiratory infections in both males and females, malignant tumours in females and diabetes mellitus and intentional injuries in males.