Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Shijingshan District, Beijing.
Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
Int J Surg. 2024 Apr 1;110(4):1951-1967. doi: 10.1097/JS9.0000000000001071.
Hernias, particularly inguinal, femoral, and abdominal, present a global health challenge. While the global burden of disease (GBD) study offers insights, systematic analyses of hernias remain limited. This research utilizes the GBD dataset to explore hernia implications, combining current statistics with 2030 projections and frontier analysis.
We analyzed data from the 2019 GBD Study, focusing on hernia-related metrics: prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories, grouped into 21 GBD regions by the socio-demographic index (SDI). Data analysis encompassed relative change calculations, as well as annual percentage change (APC) and average annual percentage change (AAPC), both of which are based on joinpoint regression analysis. The study additionally employed frontier analysis and utilized the Bayesian age-period-cohort model for predicting trends up to 2030. Analyses utilized R version 4.2.3.
From 1990 to 2019, the global prevalence of hernia cases surged by 36%, reaching over 32.5 million, even as age-standardized rates declined. A similar pattern was seen in mortality and DALYs, with absolute figures rising but age-standardized rates decreasing. Gender data between 1990 and 2019 showed consistent male dominance in hernia prevalence, even as rates for both genders fell. Regionally, Andean Latin America had the highest prevalence, with Central Sub-Saharan Africa and South Asia noting significant increases and decreases, respectively. Frontier analyses across 204 countries and territories linked higher SDIs with reduced hernia prevalence. Yet, some high SDI countries, like Japan and Lithuania, deviated unexpectedly. Predictions up to 2030 anticipate increasing hernia prevalence, predominantly in males, while age-standardized death rates and age-standardized DALY rates are expected to decline.
Our analysis reveals a complex interplay between socio-demographic factors and hernia trends, emphasizing the need for targeted healthcare interventions. Despite advancements, vigilance and continuous research are essential for optimal hernia management globally.
疝，特别是腹股沟疝、股疝和腹疝，对全球健康构成挑战。虽然全球疾病负担（GBD）研究提供了一些见解，但疝的系统分析仍然有限。本研究利用 GBD 数据集探讨疝的影响，将当前统计数据与 2030 年预测值相结合，并进行前沿分析。
我们分析了 2019 年 GBD 研究的数据，重点关注疝相关指标：204 个国家和地区的患病率、发病率、死亡率和伤残调整生命年（DALY），按社会人口指数（SDI）分为 21 个 GBD 区域。数据分析包括相对变化计算，以及年度百分比变化（APC）和平均年度百分比变化（AAPC），两者均基于连接点回归分析。该研究还采用了前沿分析，并利用贝叶斯年龄-时期-队列模型预测 2030 年的趋势。分析使用 R 版本 4.2.3 进行。
从 1990 年到 2019 年，全球疝病例的患病率增长了 36%，达到 3250 多万例，尽管年龄标准化率有所下降。死亡率和 DALY 也呈现出类似的模式，绝对数字上升，但年龄标准化率下降。1990 年至 2019 年的性别数据显示，疝的患病率一直以男性为主，尽管两性的患病率都有所下降。区域方面，安第斯拉丁美洲的患病率最高，中撒哈拉以南非洲和南亚的患病率分别显著上升和下降。对 204 个国家和地区的前沿分析表明，较高的 SDI 与较低的疝患病率相关。然而，一些高 SDI 国家，如日本和立陶宛，出人意料地出现了偏离。到 2030 年的预测显示，疝的患病率将主要在男性中增加，而年龄标准化死亡率和年龄标准化 DALY 率预计将下降。
我们的分析揭示了社会人口因素与疝趋势之间的复杂相互作用，强调需要针对特定的医疗保健干预措施。尽管取得了进展，但在全球范围内，对疝的管理仍需要保持警惕和持续研究。
