Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

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Résumé

BACKGROUND: Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. FINDINGS: Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (-6·1%, -17·2 to 1·5), and YLDs (-1·5%, -5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15-19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45-54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. INTERPRETATION: Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. FUNDING: Bill & Melinda Gates Foundation.

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La notice

Revue

The Lancet Neurology

Thématique

Spinal Cord Injury Research

Domaine

Medicine

Établissements canadiens

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Organismes subventionnaires

Stanford Cardiovascular Institute, School of Medicine, Stanford UniversityNational Heart, Lung, and Blood InstituteUniversity of California, IrvineUniversidade Federal de Minas GeraisRajshahi UniversityKing Abdullah International Medical Research CenterWenzhou Medical UniversityRajarata University of Sri LankaUniversity of ThessalyDivision of Human Resource DevelopmentSyddansk UniversitetBahir Dar UniversityWeill Cornell Medical CollegeDire Dawa UniversityGuilan University of Medical SciencesNorth-West UniversityHelsingin YliopistoSüleyman Demirel ÜniversitesiMazandaran University of Medical SciencesKing Abdulaziz UniversityDilla UniversityIslamic Azad UniversityBirjand University of Medical SciencesFundación Valle del LiliMcMaster UniversityJordan University of Science and TechnologyUniversity of OxfordWuhan UniversityUniversity of TabrizAin Shams UniversityMenofia UniversityShahrekord UniversityYale UniversityUniversity of QueenslandImperial College LondonManipal Academy of Higher EducationIsfahan University of Medical SciencesTrường Đại học Duy TânKasturba Medical College, ManipalKing Saud UniversityInstitute for Health Metrics and EvaluationPublic Health EnglandNational Institutes of HealthSchool of Medicine, Case Western Reserve UniversityFlinders UniversityNational University of SingaporeShahrekord University of Medical SciencesCase Western Reserve UniversityTabriz University of Medical SciencesBill and Melinda Gates Foundation

Mots-clés

Burden of diseaseSpinal cord injuryMedicineDiseaseDisease burdenPhysical medicine and rehabilitationSpinal cordPsychiatryInternal medicine

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