Zhong Huiming, Feng Yiping, Shen Jian, Rao Taiwen, Dai Haijiang, Zhong Wen, Zhao Guangfeng
Department of Emergency, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Am J Prev Med. 2025 Apr;68(4):754-763. doi: 10.1016/j.amepre.2025.01.001. Epub 2025 Jan 8.
This study aimed to evaluate the burden and underlying causes of traumatic brain injury (TBI) in 204 countries and territories from 1990 to 2021.
Utilizing data from the Global Burden of Disease 2021 study, which derived estimates of TBI burden from hospital and emergency department records, national surveys, and claims data, the incidence, prevalence, and years lived with disability (YLDs) associated with TBI were analyzed. A comparative analysis of TBI burden by location, age, sex, and sociodemographic index was performed, along with an underlying assessment of 15 major causes contributing to age-standardized incidence rates. Analyses were conducted in 2024.
In 2021, there were 20.84 million (95% uncertainty interval [UI]=18.13, 23.84) incident cases and 37.93 million (95% UI=36.33, 39.77) prevalent cases of TBI globally, resulting in 5.48 million (95% UI=3.87, 7.33) YLDs. While the absolute number increased from 1990 to 2021, age-standardized rates of TBI incidence, prevalence, and YLDs showed a significant decline. These rates generally increased with age and were higher in males than females. The highest age-standardized prevalence and YLD rates were observed in Eastern and Central Europe. Globally, falls were the leading cause of TBI in 2021, followed by road injuries, interpersonal violence, and exposure to mechanical forces.
Despite declines in age-standardized rates, the total number of TBI cases and associated disabilities has risen since 1990, indicating a persistent global burden. Targeted interventions are urgently needed in high-burden regions like Eastern and Central Europe, with focus on leading causes and vulnerable populations.
本研究旨在评估1990年至2021年期间204个国家和地区的创伤性脑损伤（TBI）负担及其潜在原因。
利用《2021年全球疾病负担研究》的数据，该研究从医院和急诊科记录、全国调查及理赔数据中得出TBI负担的估计值，分析了与TBI相关的发病率、患病率和伤残调整生命年（YLDs）。按地点、年龄、性别和社会人口指数对TBI负担进行了比较分析，并对导致年龄标准化发病率的15个主要原因进行了潜在评估。分析于2024年进行。
2021年，全球有2084万例（95%不确定区间[UI]=1813万，2384万）TBI新发病例和3793万例（95% UI=3633万，3977万）TBI现患病例，导致548万例（95% UI=387万，733万）YLDs。虽然从1990年到2021年绝对数量有所增加，但TBI发病率、患病率和YLDs的年龄标准化率呈显著下降。这些比率一般随年龄增长而上升，男性高于女性。东欧和中欧的年龄标准化患病率和YLD率最高。2021年，全球范围内，跌倒为TBI的主要原因，其次是道路伤害、人际暴力和机械力暴露。
尽管年龄标准化率有所下降，但自1990年以来TBI病例总数及相关残疾数有所上升，表明全球负担持续存在。在东欧和中欧等高负担地区迫切需要有针对性的干预措施，重点关注主要原因和弱势群体。
