Wei Jiyong, He Dezhi, Lan Guipeng, Xu Minglian, Guo Jianfeng, Lan Yanni, Zong Shaohui
Department of Spine Osteopathia, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Spine Surgery, The First People's Hospital of Nanning, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Front Public Health. 2025 Jun 18;13:1610604. doi: 10.3389/fpubh.2025.1610604. eCollection 2025.
Fractures of the pelvis are significant orthopedic injuries associated with high morbidity, mortality, and substantial economic burden worldwide.
This study aimed to comprehensively analyze the disease burden of pelvic fractures globally from 1990 to 2021 using data from the Global Burden of Disease (GBD) Study 2021. First, we conducted a descriptive analysis in 2021, stratifying data by subtypes. Secondly, we used the Linear regression models to analyze temporal trends. Finally, we used two models to predict the future burden. Furthermore, we examined the correlation between estimated annual percentage change (EAPCs) and age-standardized rates (ASRs), as well as Human Development Index (HDI) scores in 2021.
In 2021, pelvic fractures caused 4,524,448 incident cases (95% UI 3,283,345-6,583,735), 13,100,257 prevalent cases (12,103,233-14,174,613), and 2,241,606 years lived with disability (YLDs; 1,559,349-2,965,288). The age-standardized incidence rate (ASIR) was 56.00 per 100,000 (40.96-81.22), age-standardized prevalence rate (ASPR) 155.97 (143.85-168.87), and YLDs rate 26.74 (18.59-35.36). Rates were higher in males, with ASIR, ASPR, and YLDs 1.14, 1.35, and 1.37 times those in females. Age-specific ASRs rose with age. Australasia had the highest ASIR (148.39; 101.02-219.91), and the Commonwealth Low-Income region the lowest (21.97; 16.86-29.23). Western Africa recorded the lowest ASPR (77.37; 70.44-86.42) and YLD rate (13.34; 9.39-18.00). Nationally, ASIR was highest in Andorra (176.62; 111.81-281.70) and lowest in Kiribati (17.96; 13.88-23.10). Projections suggest rising burden through 2046. EAPCs were inversely associated with ASRs and HDI, except for a weak, non-significant positive correlation with ASIR (ρ = 0.08; = 0.27).
Our findings reveal a substantial and increasing global burden of pelvic fractures, particularly in regions with limited access to high-quality trauma care. The increasing proportion of years lived with disability (YLDs) due to long-term disability underscores the importance of comprehensive management strategies, including prevention, timely treatment, and effective rehabilitation.
骨盆骨折是严重的骨科损伤，在全球范围内与高发病率、高死亡率及巨大的经济负担相关。
本研究旨在利用《2021年全球疾病负担研究》的数据，全面分析1990年至2021年全球骨盆骨折的疾病负担。首先，我们在2021年进行了描述性分析，按亚型对数据进行分层。其次，我们使用线性回归模型分析时间趋势。最后，我们使用两种模型预测未来负担。此外，我们考察了2021年估计年百分比变化（EAPCs）与年龄标准化率（ASRs）以及人类发展指数（HDI）得分之间的相关性。
2021年，骨盆骨折导致4,524,448例新发病例（95%不确定区间3,283,345 - 6,583,735）、13,100,257例现患病例（12,103,233 - 14,174,613）以及2,241,606伤残调整生命年（YLDs；1,559,349 - 2,965,288）。年龄标准化发病率（ASIR）为每10万人56.00例（40.96 - 81.22），年龄标准化患病率（ASPR）为155.97（143.85 - 168.87），YLDs率为26.74（18.59 - 35.36）。男性的发病率更高，ASIR、ASPR和YLDs分别是女性的1.14倍、1.35倍和1.37倍。特定年龄的ASRs随年龄增长而上升。澳大拉西亚地区的ASIR最高（148.39；101.02 - 219.91），英联邦低收入地区最低（21.97；16.86 - 29.23）。西非地区的ASPR最低（77.37；70.44 - 86.42），YLD率最低（13.34；9.39 - 18.00）。在国家层面，安道尔的ASIR最高（176.62；111.81 - 281.70），基里巴斯最低（17.96；13.88 - 23.10）。预测表明到2046年负担将持续上升。EAPCs与ASRs和HDI呈负相关，但与ASIR呈微弱的、不显著的正相关（ρ = 0.08；P = 0.27）。
我们的研究结果揭示了全球骨盆骨折负担巨大且呈上升趋势，尤其是在获得高质量创伤护理机会有限的地区。因长期残疾导致的伤残调整生命年（YLDs）比例不断增加，凸显了综合管理策略的重要性，包括预防、及时治疗和有效康复。
