Research Article: Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Abstract:
Objectives To evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories. Design An analysis of Global Burden of Disease (GBD) data. Setting The epidemiological data were gathered from GBD Results Tool (1 January, 1990?31 December 2019) covering 21 GBD regions and 204 countries/ territories. Participants Patients with TBI/SCI. Main outcomes and measures Absolute numbers and age-standardised rates/estimates of incidence, prevalence and years lived with disability (YLDs) of TBI/SCI by location in 2019, with their percentage changes from 1990 to 2019. The leading causes (eg, falls) of TBI/SCI in 204 countries/territories. Results Globally, in 2019, TBI had 27.16 million new cases, 48.99 million prevalent cases and 7.08 million YLDs. SCI had 0.91 million new cases, 20.64 million prevalent cases and 6.20 million YLDs. Global age-standardised incidence rates of TBI decreased significantly by ?5.5% (95% uncertainty interval ?8.9% to ?3.0%) from 1990 to 2019, whereas SCI had no significant change (?6.1% (?17.3% to 1.5%)). Regionally, in 2019, Eastern Europe and High-income North America had the highest burden of TBI and SCI, respectively. Nationally, in 2019, Slovenia and Afghanistan had the highest age-standardised incidence rates of TBI and SCI, respectively. For TBI, falls were the leading cause in 74% (150/204) of countries/territories, followed by pedestrian road injuries (14%, 29/204), motor vehicle road injuries (5%, 11/204), and conflict and terrorism (2%, 4/204). For SCI, falls were the leading cause in 97% (198/204) of countries/territories, followed by conflict and terrorism (3%, 6/204). Conclusions Global age-standardised incidence rates of TBI have decreased significantly since 1990, whereas SCI had no significant change. The leading causes of TBI/SCI globally were falls, but variations did exist between countries/territories. Policy-makers should continue to prioritise interventions to reduce falls, but priorities may vary between countries/territories.
Introduction:
Traumatic brain injury (TBI) and spinal cord injury (SCI) continue to pose challenges to the global public health systems, and the resulting disabilities have brought a huge economic burden to patients, public health systems and societies. 1 2 Compared with the previous Global Burden of Disease (GBD) 2016 Study, 3 4 new available data sources and improved statistical methods in the GBD 2019 Study led to the GBD 2019 results superseding those from previous rounds of GBD. 5 Besides, nine additional…
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