Gu Long, Zhang Lihan, Li Chun, Jiang Lu, Zhou Jian, Xie Yuke, Yang JieRu, Jiang Chuan, Zhang Lifang, Jiang Yong, Peng Jianhua
Department of Neurosurgery, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
J Neurotrauma. 2025 Jul 7. doi: 10.1089/neu.2025.0039.
Traumatic brain injury (TBI) is a major global health concern, contributing substantially to mortality and disability. While previous studies have reported the global and regional burden of TBI, few have explored its long-term trends, cause-specific burden, sociodemographic disparities, and future projections in a comprehensive framework. To address this gap, we conducted a retrospective analysis using the Global Burden of Disease 2021 data to estimate TBI incidence, prevalence, and years lived with disability across sex, age, and Sociodemographic Index (SDI) quintiles. We used average annual percent change (AAPC) to evaluate temporal trends from 1990 to 2021 and applied Spearman's correlation to examine the association between age-standardized incidence rate (ASIR) and SDI. Projections of future trends were made using an autoregressive integrated moving average model. The results revealed that global TBI cases increased from 17.0 million in 1990 to 20.8 million in 2021, although the global ASIR decreased from 324.43 to 259.02 per 100,000, with an AAPC of -0.80%. The age-standardized prevalence rate (ASPR) also declined in high SDI locations, from 539.7 to 425.9 per 100,000 (AAPC: -0.76%), with similar declines observed in high-middle SDI locations. Southern Sub-Saharan Africa showed the largest reductions, whereas Oceania experienced a slight increase in ASIR, largely driven by falls and road injuries, with notable gender-specific patterns. By 2031, TBI incidence rates are projected to decline for both sexes, with falls remaining stable and road injuries decreasing. While the ASIR and ASPR of TBI have decreased, the absolute number of cases has risen, underscoring the need for public health interventions that consider regional differences in TBI trends and causes in order to effectively reduce the burden.
创伤性脑损伤（TBI）是一个重大的全球健康问题，对死亡率和残疾率有重大影响。虽然先前的研究报告了TBI的全球和区域负担，但很少有研究在一个综合框架中探讨其长期趋势、特定病因负担、社会人口统计学差异以及未来预测。为了填补这一空白，我们使用2021年全球疾病负担数据进行了一项回顾性分析，以估计TBI在性别、年龄和社会人口统计学指数（SDI）五分位数中的发病率、患病率和残疾生存年数。我们使用平均年度百分比变化（AAPC）来评估1990年至2021年的时间趋势，并应用斯皮尔曼相关性来检验年龄标准化发病率（ASIR）与SDI之间的关联。使用自回归积分移动平均模型对未来趋势进行预测。结果显示，全球TBI病例从1990年的1700万例增加到2021年的2080万例，尽管全球ASIR从每10万人324.43例降至259.02例，AAPC为-0.80%。高SDI地区的年龄标准化患病率（ASPR）也有所下降，从每10万人539.7例降至425.9例（AAPC：-0.76%），高中SDI地区也有类似下降。撒哈拉以南非洲南部降幅最大，而大洋洲的ASIR略有上升，主要由跌倒和道路伤害导致，存在明显的性别特定模式。到2031年，预计男女的TBI发病率均会下降，跌倒保持稳定，道路伤害减少。虽然TBI的ASIR和ASPR有所下降，但病例绝对数有所上升，这凸显了需要采取公共卫生干预措施，考虑TBI趋势和病因的区域差异，以有效减轻负担。
