{"id":2630,"date":"2015-08-28T20:09:00","date_gmt":"2015-08-28T20:09:00","guid":{"rendered":"https:\/\/cdafound.org\/?p=2630"},"modified":"2025-01-16T15:33:42","modified_gmt":"2025-01-16T15:33:42","slug":"global-regional-and-national-disability-adjusted-life-years-dalys-for-306-diseases-and-injuries-and-healthy-life-expectancy-hale-for-188-countries-1990-2013-quantifying-the-epidemiological-tra","status":"publish","type":"post","link":"https:\/\/cdafound.org\/es\/global-regional-and-national-disability-adjusted-life-years-dalys-for-306-diseases-and-injuries-and-healthy-life-expectancy-hale-for-188-countries-1990-2013-quantifying-the-epidemiological-tra\/","title":{"rendered":"A\u00f1os de vida ajustados por discapacidad (AVAD) a nivel mundial, regional y nacional para 306 enfermedades y lesiones y esperanza de vida saludable (HALE) para 188 pa\u00edses, 1990-2013: cuantificaci\u00f3n de la transici\u00f3n epidemiol\u00f3gica"},"content":{"rendered":"

Resumen<\/h2>\n\n\n\n

Fondo <\/h3>\n\n\n\n

El Global Burden of Disease Study 2013 (GBD 2013) tiene como objetivo reunir todos los datos epidemiol\u00f3gicos disponibles utilizando un marco de medici\u00f3n coherente, m\u00e9todos de estimaci\u00f3n estandarizados y fuentes de datos transparentes para permitir comparaciones de la p\u00e9rdida de salud a lo largo del tiempo y entre causas, grupos de edad y sexo, y pa\u00edses. El GBD se puede utilizar para generar medidas resumidas, como a\u00f1os de vida ajustados por discapacidad (AVAD) y esperanza de vida saludable (HALE), que posibilitan evaluaciones comparativas de patrones epidemiol\u00f3gicos amplios entre pa\u00edses y \u00e9pocas. Estas medidas de resumen tambi\u00e9n se pueden utilizar para cuantificar el componente de variaci\u00f3n en la epidemiolog\u00eda que est\u00e1 relacionado con el desarrollo sociodemogr\u00e1fico. <\/p>\n\n\n\n

M\u00e9todos <\/h3>\n\n\n\n

Usamos los datos publicados de GBD 2013 para la mortalidad espec\u00edfica por edad, los a\u00f1os de vida perdidos debido a la mortalidad prematura (AVP) y los a\u00f1os vividos con discapacidad (AVD) para calcular los AVAD y la EHA para 1990, 1995, 2000, 2005, 2010 y 2013 para 188 pa\u00edses. Calculamos HALE utilizando el m\u00e9todo de Sullivan; Los intervalos de incertidumbre (IU) 95% representan la incertidumbre en las tasas de mortalidad espec\u00edficas por edad y los AVD por persona para cada pa\u00eds, edad, sexo y a\u00f1o. Estimamos AVAD para 306 causas para cada pa\u00eds como la suma de AVP y AVD; Las UI 95% representan incertidumbre en las tasas de AVP y AVD. Cuantificamos los patrones de la transici\u00f3n epidemiol\u00f3gica con un indicador compuesto de estatus sociodemogr\u00e1fico, que construimos a partir del ingreso por persona, los a\u00f1os promedio de escolaridad despu\u00e9s de los 15 a\u00f1os, y la tasa de fecundidad total y la edad promedio de la poblaci\u00f3n. Aplicamos regresi\u00f3n jer\u00e1rquica a las tasas de AVAD por causa entre pa\u00edses para descomponer la varianza relacionada con la variable de estado sociodemogr\u00e1fico, el pa\u00eds y el tiempo. <\/p>\n\n\n\n

Recomendaciones <\/h3>\n\n\n\n

En todo el mundo, de 1990 a 2013, la esperanza de vida al nacer aument\u00f3 6,2 a\u00f1os (95% UI: 5,6 a 6,6), de 65,3 a\u00f1os (65,0 a 65,6) en 1990 a 71,5 a\u00f1os (71,0 a 71,9) en 2013, la HALE al nacer aument\u00f3 5,4 a\u00f1os (4,9 a 5,8), de 56,9 a\u00f1os (54,5 a 59,1) a 62,3 a\u00f1os (59,7 a 64,8), los AVAD totales se redujeron en 3,61 TP1T (0,3 a 7,4) y las tasas de AVAD estandarizadas por edad por 100.000 personas se redujeron en 26,7% (24,6 \u201329,1). Para los trastornos transmisibles, maternos, neonatales y nutricionales, las cifras globales de AVAD, las tasas brutas y las tasas estandarizadas por edad han disminuido entre 1990 y 2013, mientras que para las enfermedades no transmisibles, los AVAD globales han aumentado, las tasas de AVAD se han mantenido casi constantes y las tasas de AVAD estandarizadas por edad disminuyeron durante el mismo per\u00edodo. De 2005 a 2013, el n\u00famero de AVAD aument\u00f3 para la mayor\u00eda de las enfermedades no transmisibles espec\u00edficas, incluidas las enfermedades cardiovasculares y las neoplasias, adem\u00e1s del dengue, los trematodos transmitidos por los alimentos y la leishmaniasis; Los AVAD disminuyeron por casi todas las dem\u00e1s causas. Para 2013, las cinco causas principales de AVAD fueron la cardiopat\u00eda isqu\u00e9mica, las infecciones de las v\u00edas respiratorias inferiores, las enfermedades cerebrovasculares, el dolor lumbar y de cuello y los traumatismos causados por la carretera. El estado sociodemogr\u00e1fico explic\u00f3 m\u00e1s del 50% de la variaci\u00f3n entre pa\u00edses y con el tiempo para la diarrea, las infecciones de las v\u00edas respiratorias inferiores y otras enfermedades infecciosas comunes; trastornos maternos; trastornos neonatales; deficiencias nutricionales; otras enfermedades transmisibles, maternas, neonatales y nutricionales; trastornos musculoesquel\u00e9ticos; y otras enfermedades no transmisibles. Sin embargo, el estado sociodemogr\u00e1fico explic\u00f3 menos de 10% de la varianza en las tasas de AVAD para las enfermedades cardiovasculares; enfermedades respiratorias cr\u00f3nicas; cirrosis; diabetes, enfermedades urogenitales, sangu\u00edneas y endocrinas; lesiones no intencionales; y autolesiones y violencia interpersonal. Como era de esperar, el aumento del estado sociodemogr\u00e1fico se asoci\u00f3 con un cambio en la carga de los AVP a los AVD, impulsado por la disminuci\u00f3n de los AVP y el aumento de los AVD por trastornos musculoesquel\u00e9ticos, trastornos neurol\u00f3gicos y trastornos mentales y por uso de sustancias. En la mayor\u00eda de las estimaciones espec\u00edficas de cada pa\u00eds, el aumento de la esperanza de vida fue mayor que el de HALE. Las principales causas de AVAD var\u00edan mucho entre pa\u00edses. <\/p>\n\n\n\n

Interpretaci\u00f3n <\/h3>\n\n\n\n

La salud mundial est\u00e1 mejorando. El crecimiento y el envejecimiento de la poblaci\u00f3n han aumentado el n\u00famero de AVAD, pero las tasas brutas se han mantenido relativamente constantes, lo que demuestra que el progreso en la salud no significa menos demandas para los sistemas de salud. La noci\u00f3n de una transici\u00f3n epidemiol\u00f3gica, en la que el aumento del estatus sociodemogr\u00e1fico trae un cambio estructurado en la carga de morbilidad, es \u00fatil, pero existe una enorme variaci\u00f3n en la carga de morbilidad que no est\u00e1 asociada con el estatus sociodemogr\u00e1fico. Esto subraya a\u00fan m\u00e1s la necesidad de evaluaciones espec\u00edficas de cada pa\u00eds de AVAD y HALE para informar adecuadamente las decisiones de pol\u00edtica de salud y las acciones concomitantes.<\/p>\n\n

\n
Lea el informe completo<\/a><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"

Summary Background The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age\u2013sex groups, and countries. The GBD can be used to generate summary measures 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