Toward pecision-based prevention: trends in the burden of adverse effects of medical treatment in China based on GBD data and identification of high-risk elderly male groups

To analyze the status and trends of the burden of adverse effects of medical treatment (AEMT) in China from 1990 to 2023 using open data from the Global Burden of Disease (GBD) 2023.

Based on the GBD 2023 data, we extracted the number of incident cases, prevalent cases, disability-adjusted life years (DALYs), and deaths due to AEMT in China from 1990 to 2023. We also extracted age-standardized rates, including the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized DALYs rate (ASDR), and age-standardized mortality rate (ASMR). The annual percent change (APC), average annual percent change (AAPC), and their 95% confidence intervals (95% CI) for ASIR, ASPR, ASDR, and ASMR were calculated to analyze trends in the burden of AEMT in China. Epidemiological characteristics and differences in the AEMT burden among different age and sex groups in China were compared for the years 1990, 2020, and 2023.

From 1990 to 2023, the number of incident cases, prevalent cases, DALYs, and deaths due to AEMT in China changed from 432 784 (95%UI: 347 489 to 526 244), 33 087 (95%UI: 24 103 to 42 381), 686 404 (95%UI: 398 451 to 1 086 894), and 11 426 (95%UI: 7 233 to 17 456) to 342 349 (95%UI: 279 429 to 423 443), 26 165 (95%UI: 19 529 to 33 662), 121 245 (95%UI: 90 707 to 155 623), and 3 337 (95%UI: 2 494 to 4 212) in 2020, and further to 372 069 (95%UI: 303 152 to 464 618), 28 436 (95%UI: 21 029 to 36 643), 107 384 (95%UI, 79 527 to 137 417), and 3 128 (95%UI: 2 305 to 3 985) in 2023. From 1990 to 2023, the AAPC values for ASIR, ASPR, ASDR, and ASMR were -0.994 8% (95%CI: -1.199 7% to -0.789 5%), -0.993 3% (95%CI: -1.202 2% to -0.783 9%), -5.968 4% (95%CI: -6.195 9% to -5.740 3%), and -5.432 2% (95%CI: -5.658 8% to -5.205 1%), respectively (P<0.05). In 1990, incidence and mortality rates were higher in younger age groups and among females compared to males, while rates were higher among older males compared to older females. In 2020 and 2023, incidence was higher among females than males in younger age groups and higher among older males than older females; the differences in incidence rates between males and females within the same age group and year narrowed compared to 1990, while mortality among older males remained higher than among females in the same periods.

From 1990 to 2023, key indicators of the AEMT burden in China-incidence, prevalence, DALYs, and mortality-showed an overall declining trend. Among the elderly population, AEMT incidence and mortality increased with age, and elderly males were more likely to die from AEMT than elderly women.

Enhancing investment in medical training and resources to improve the capability for diagnosing and treating AEMT, continuously strengthening AEMT prevention and control, and implementing tailored interventions for the elderly, particularly elderly males.