Global Burden and Epidemiologic Transition of Adverse Effects of Medical Treatment: A 30-year Analysis.

Abstract

Background: Adverse effects of medical treatment (AEMT) pose a substantial global health burden, yet their epidemiological profile remains incompletely characterized. This multinational study aims to characterize the burden of AEMT to guide the development of evidence-based, targeted prevention strategies across diverse health systems.

Methods: This study analyzed the global epidemiology of AEMT from 1990 to 2021 using data from the GBD study. Age-standardized rates with 95% UIs were obtained for incidence (ASIR), mortality (ASMR), YLDs, YLLs, and DALYs to systematically evaluate the burden of AEMT. Furthermore, the Epidemiological Transition Effect (ETE) index was introduced to quantify shifts in AEMT burden patterns. Percentage changes with 95% UIs for each metric were calculated between 1990 and 2021. Subgroup analyses were also conducted stratified by age, sex, and region.

Results: The global ASIR of AEMT was estimated at 150.11 per 100,000 (95% UIs: 131.19-171.81) in 2021. Meanwhile, the global ASMR in 2021 was 1.53 per 100,000, reflecting a 36% decrease since 1990. Similarly, the YLLs fell to 62.66 per 100,000, a reduction of 40% compared with 1990. In the same year, the global YLDs were 1.53 per 100,000. From 1990 to 2021, DALYs attributable to AEMT declined by 40%, reaching 64.19 per 100,000 population in 2021. Children under 5 years demonstrated disproportionately high YLLs and DALYs. The global ETE value was low at 0.02, indicating that the burden of AEMT was primarily driven by premature mortality. Significant sex disparity was observed, with higher burden rates among females and pronounced peaks among.

Conclusions: This comprehensive analysis reveals a significant global reduction in the AEMT burden since 1990. Given the disproportionately high burden observed among children-characterized by substantial YLLs due to premature mortality-public health strategies should address not only fatal AEMT events but also prioritize targeted interventions for this vulnerable pediatric population.