Table 3.
Sensitivity analysis of pooled ASMR per 100,000 population from premature CVD mortality by excluding the studies outlier
| After removed outlier | Comparison with original data | |||||
|---|---|---|---|---|---|---|
| Subgroup | n | ASMR (95% CI) |
I2 (%) | n | ASMR (95% CI) |
I2 (%) |
| Overall study | 13 | 31.20 (23.81, 40.89) | 97 | 15 | 27.00 (20.13, 36.21) | 99 |
| CVD types | ||||||
| Total CVDa | 6 | 46.69 (28.63, 76.15) | 29 | 8 | 96.04 (67.18, 137.31) | 84 |
| IHDb | 3 | 20.67 (12.41, 34.45) | 74 | 4 | 15.57 (11.27, 21.51) | 92 |
| Strokec | 3 | 12.23 (10.55, 14.17) | 86 | 4 | 12.36 (8.09, 18.91) | 97 |
| Sex | ||||||
| Male | 8 | 46.23 (31.95, 66.90) | 93 | 10 | 37.50 (23.69, 59.37) | 96 |
| Female | 8 | 18.87 (11.99, 29.70) | 97 | 10 | 15.75 (9.61, 25.81) | 99 |
| Country income classificatione | ||||||
| HIC | 9 | 26.53 (19.61, 35.91) | 97 | 10 | 21.42 (15.63, 29.37) | 99 |
| MIC | 5 | 121.56 (70.05, 210.95) | 40 | 6 | 90.58 (56.40, 145.48) | 77 |
| Time study (year) | ||||||
| 1990–1999 | 3 | 21.40 (14.68, 31.19) | 68 | 4 | 16.35 (8.35, 32.02) | 96 |
| 2000–2009 | 4 | 112.85 (64.87, 196.32) | 85 | 5 | 63.84 (35.34, 115.31) | 98 |
| 2010–2019 | 9 | 23.25 (16.76, 32.24) | 97 | 10 | 19.93 (13.56, 29.30) | 99 |
| Specific subgroup analysis | ||||||
| HIC by study time | ||||||
| 1990–1999 | 3 | 21.40 (14.68, 31.19) | 68 | 4 | 16.35 (8.35, 32.2) | 96 |
| 2000–2009 | 3 | 40.47 (16.19, 101.22) | 97 | 3 | 40.47 (16.19, 101.22) | 99 |
| 2010–2019 | 5 | 21.84 (14.99, 31.81) | 96 | 6 | 18.47 (11.89, 28.67) | 99 |
| MIC by study time | ||||||
| 2000–2009 | 3 | 172.55 (109.64, 271.55) | 12 | 3 | 172.55 (109.64, 271.55) | 12 |
| 2010–2019 | 3 | 22.10 (3.29, 148.74) | 0 | 4 | 50.89 (45.62, 56.77) | 0 |
| Total CVDa by sex | ||||||
| Male | 4 | 81.68 (23.63, 282.35) | 0 | 5 | 181.86 (112.98, 292.76) | 0 |
| Female | 4 | 32.36 (11.30, 92.68) | 40 | 5 | 72.69 (30.04, 175.91) | 85 |
| IHDb by sex | ||||||
| Male | 3 | 45.07 (24.44, 82.13) | 0 | 4 | 27.51 (17.89, 42.30) | 68 |
| Female | 3 | 11.18 (7.42, 16.86) | 46 | 4 | 9.30 (6.64, 13.03) | 83 |
| Strokec by sex | ||||||
| Male | 2 | 14.40 (0.65, 316.68) | 11 | 3 | 15.18 (10.12, 22.77) | 28 |
| Female | 2 | 10.54 (8.22, 13.50) | 0 | 3 | 7.23 (2.45, 21.29) | 99 |
n number of studies, CVD cardiovascular disease, ASMR age standardized mortality rate (ASMR) per 100,000. Random effect model applied pool estimate of ASMR, 95% CI = 95% confident interval of estimated ASMR
atotal CVD death was based on ICD -10 code: I00-I99 or ICD-9 codes: 350–459
bIschemic heart disease (IHD) death based on ICD-10 (I20-I25) or ICD-9 (410–414)
cCerebrovascular disease or stroke death based on ICD-10 (I60-I69) or ICD-9 (430–438)
dOther types of CVD death including heart disease (ICD-10: I00-I09, I11, I13, I20- I51), heart failure (ICD-10: I50) and cardiac death ICD-10 (I21, I25, I40, I34, I35, I42, I45-I49, R96, Q20-Q24, Q87)
eAccording to World Bank’s classification. HICs = high income countries, MICs = middle-income counties (including upper middle-income countries and low middle-income countries)
Outlier removed for each subgroup as below;
– Overall study: Jin et.al, (2020) and Gómez-Martínez et al. (2018)
– Total CVD: Yang et al. (2021) and Gawryszewski & Souza (2014)
– IHD: Dani et al. (2022)
– Stroke: Moryson & Stawińska (2022)
– Male and female: Best et al. (2018) and Gómez-Martínez et al. (2018)
– Study time year 1990–1999: Gómez-Martínez et al. (2018)
– Study time year 2000–2009: Moryson & Stawińska (2022)
– Study time year 2010–2019: Gómez-Martínez et al. (2018)
– High-income countries: Gómez-Martínez et al. (2018)
– Middle-income countries: Yang et al. (2021)