Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021

Abstract

Background/aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021.

Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed.

Results: In 2021, the global age-standardized prevalence, incidence, disability-adjusted life years (DALYs), and mortality rates of AEMT were 11.48 (95% uncertainty interval [UI], 8.86-14.13), 150.44 (131.19-171.81), 64.19 (51.06-73.11), and 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles.

Conclusion: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.

Keywords: Adverse effect; Disability-adjusted life years; Global Burden of Disease; Incidence; Mortality.

Figure 1

Global distribution of age-standardized prevalence, incidence, DALYs, and mortality rate (per 100,000 population) for adverse effects of medical treatments in both sexes, 2021. DALYs, disability-adjusted life years.

Figure 2

Total case and rate (per 100,000 population) of key metrics for adverse effects of medical treatments, globally and by age groups and sex, 2021. (A) Prevalence, (B) incidence, (C) DALYs, and (D) mortality. DALYs, disability-adjusted life-years. Shaded regions indicate

Figure 3

Rates (per 100,000 population) of key metrics for adverse effects of medical treatments by SDI and age groups, 2021. (A) Prevalence, (B) incidence, (C) DALYs, and (D) mortality. DALYs, disability-adjusted life years; SDI, Socio-demographic Index.

Figure 4

MIRs for adverse effects of medical treatments in both sexes. (A) By age and SDI groups, 2021. (B) Percentage change by SDI and age groups from 1990 to 2021. MIRs, mortality-incidence ratios; SDI, Socio-demographic Index.

Figure 5

Correlation between Healthcare Access and Quality Index and key metrics for adverse effects of medical treatment, 2021. (A) Prevalence rate, (B) incidence rate, (C) DALYs rate, and (D) mortality rate. DALYs, disability-adjusted life years; SDI, Socio-demographic Index.