Global burden of amputation among children and adolescents from 1990 to 2021: systematic analysis of the Global Burden of Disease study 2021.

INTRODUCTION

Amputation among children and adolescents, with its substantial physical, psychological, and economic impacts, remains a significant global health issue.

OBJECTIVES

This study uses data from the Global Burden of Disease (GBD) to examine trends in amputation burden among youth aged 0-19 from 1990 to 2021.

METHODS

This study utilized the 2021 GBD dataset, focusing on the incidence, prevalence, and years lived with disabilities (YLDs) associated with amputations. We applied pinpoint regression and age-period-cohort models to explore trends across the socio-demographic index (SDI) regions, GBD regions, and sex groups from 1990 to 2021, while also forecasting the burden of amputations up to 2040.

RESULTS

We found a global decline in the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized YLDs rate (ASYR) for children and adolescents. Specifically, the ASIR decreased from 207.3 per 100,000 people in 1990 to 141.5 per 100,000 in 2021, while the ASPR declined from 2,119.6 to 1,437.8 per 100,000 people. Over the same period, YLDs dropped from 30.7 per 100,000 to 18.3 per 100,000. High-SDI countries experienced the greatest declines, reflecting improvements in healthcare and rehabilitation services. In contrast, low-SDI regions and conflict-affected countries like Afghanistan and Syria saw increments in the incidence and prevalence rates. The highest incidence was observed among males aged 15-19 years, with a relative risk of 1.28 compared with the other age groups. Projections indicate that although global incidence rates may continue declining until 2040, disparities in high-risk areas will persist without targeted interventions.

CONCLUSION

This study highlights a global decline in the burden of amputations among children and adolescents but reveals significant disparities based on SDI regions, sex, and age. Targeted public health strategies and resource allocation are, needed to address these inequalities, improve trauma care, and enhance rehabilitation services, especially in high-risk areas.