Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
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Résumé
BACKGROUND: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. FUNDING: Bill & Melinda Gates Foundation.
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La notice
- Revue
- The Lancet Neurology
- Thématique
- Spinal Cord Injury Research
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- National Institute on Deafness and Other Communication DisordersFuel Cell Technologies ProgramStudent Research Committee, Tabriz University of Medical SciencesFaculty of Medicine and Health, University of SydneyNIHR Imperial Biomedical Research CentreCollaboration for Leadership in Applied Health Research and Care - Greater ManchesterLee Kong Chian School of Medicine, Nanyang Technological UniversityInstituto de Salud Carlos IIINational Health and Medical Research CouncilMedical Research CouncilManchester Biomedical Research CentreResearch Institute, Nationwide Children's HospitalUniversity of California, IrvineNational Institutes of HealthUniversity of Health and Allied SciencesGeorge Institute for Global HealthLaboratório Associado para a Química VerdeMinistry of Health of the Russian FederationCentro de Investigação em Tecnologias e Serviços de SaúdeUniversidade Federal de SergipeFrankfurt University of Applied SciencesKurdistan University Of Medical SciencesH. Lundbeck A/SLorestan University of Medical SciencesHawassa UniversityUniversità degli Studi di MessinaGolestan University of Medical SciencesResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAlfaisal UniversityUniversity of GondarWestern Sydney UniversityTartu ÜlikoolPomorski Uniwersytet Medyczny W SzczecinieUniversidade Federal de Minas GeraisWuhan UniversityUniversidade do PortoFundação Oswaldo CruzNational Taiwan UniversityDepartment of Science and Technology, Government of KeralaUniversidad de ChileDebre Tabor UniversityUniversità di BolognaShahid Beheshti University of Medical SciencesUniversität BielefeldLomonosov Moscow State UniversityBabol University of Medical SciencesUniversidade de São PauloGuilan University of Medical SciencesHacettepe ÜniversitesiUniversitetet i OsloAhvaz Jundishapur University of Medical SciencesNIHR Oxford Biomedical Research CentreInyuvesi Yakwazulu-NataliHaramaya UniversityCurtin University of TechnologyUniversiti Sains MalaysiaErasmus Universitair Medisch Centrum RotterdamSouth African Medical Research CouncilBundesministerium für GesundheitPolitechnika CzestochowskaChinese Center for Disease Control and PreventionTabriz University of Medical SciencesTampereen YliopistoSeoul National University HospitalTsinghua UniversityDezful University of Medical SciencesFudan UniversityGuy's and St Thomas' NHS Foundation TrustLunds UniversitetAlborz University of Medical SciencesNorthwestern UniversityUniversidad Nacional de ColombiaUniversitätsklinikum HeidelbergMinistarstvo Prosvete, Nauke i Tehnološkog RazvojaMinisterio de Educación, Cultura y DeporteIslamic Azad UniversityKyung Hee UniversityNational and Kapodistrian University of AthensCairo UniversityShiraz University of Medical SciencesAin Shams UniversityKing Fahd University of Petroleum and MineralsMinisterio de Economía y CompetitividadBundesministerium für Bildung und ForschungUniversity of New South WalesMinistério da EducaçãoPublic Health AgencyNanyang Technological UniversityKaiser PermanenteMinistry of Health and Medical EducationHigh Blood Pressure Research Council of AustraliaUniversiteit StellenboschPublic Health EnglandAustralian Catholic UniversityBrien Holden Vision InstituteShiraz UniversityImperial College LondonSree Chitra Tirunal Institute for Medical Sciences and TechnologyKing's College LondonYork UniversityLoma Linda UniversityMoscow Institute of Physics and TechnologyNational Institute of Mental Health and NeurosciencesMaragheh University of Medical SciencesAddis Ababa UniversityUniversità degli Studi di FirenzeUniversidad Autónoma MetropolitanaAlexander von Humboldt-StiftungTribhuvan UniversityFundação para a Ciência e a TecnologiaRede de Química e TecnologiaAksum UniversityJohns Hopkins UniversityWellcome TrustTrường Đại học Duy TânNational Center for Global Health and MedicineTulane UniversityApplied Molecular Biosciences UnitIran University of Medical SciencesNational Institute for Health and Care ResearchKorea UniversitySanjay Gandhi Postgraduate Institute of Medical SciencesNational Institute on Handicapped ResearchNationwide Children's HospitalAmgenUniversitat de BarcelonaPublic Health Agency of CanadaUniversitat de ValènciaUniwersytet Jagielloński Collegium MedicumUniversity College LondonUniversity of SouthamptonUniversitas Negeri SemarangUniversity of TabrizEuropean CommissionAhmadu Bello UniversitySamara UniversityJordan University of Science and TechnologyUniversity of OxfordMcMaster UniversityJazan UniversityUniwersytet OpolskiGeneralitat ValencianaUniversity of Cape TownUniversity of OttawaArabian Gulf UniversityCentral South UniversityVirginia Commonwealth UniversityUniversity of Technology SydneyMuhimbili University of Health and Allied SciencesUniverzita Komenského v BratislaveUniversidade Federal de Santa CatarinaUniversity of West FloridaInternational Centre for Diarrhoeal Disease Research, BangladeshPacific Institute for Research and EvaluationUniversity of Social Welfare and Rehabilitation SciencesDeakin UniversityHelsingin YliopistoMinistério da Educação e CiênciaJackson State UniversityHarvard UniversityEuropean Regional Development FundSeoul National UniversityBill and Melinda Gates FoundationGeorg-August-Universität GöttingenNational University of SingaporeInstitute for Physical Activity and NutritionBanaras Hindu UniversityNational Institute of Mental HealthCase Western Reserve UniversityUniversity of WarwickBall State UniversityKarolinska InstitutetYale University
- Mots-clés
- Traumatic brain injurySpinal cord injuryMedicineBurden of diseaseIncidence (geometry)Injury preventionPoison controlDiseaseDisease burdenOccupational safety and healthPhysical therapyPhysical medicine and rehabilitationSpinal cordMedical emergencyPsychiatryInternal medicinePathology
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