Journal article
Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Lancet neurology, Vol.18(1), pp.56-87
01/01/2019
DOI: 10.1016/S1474-4422(18)30415-0
PMCID: PMC6291456
PMID: 30497965
Abstract
Background Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury.
Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility.
Findings In 2016, there were 27.08 million (95% uncertainty interval [UI] 24.30-30.30 million) new cases of TBI and 0.93 million (0.78-1.16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55.50 million (53.40-57.62 million) and of SCI was 27.04 million (24 .98-30 .15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8.4% (95% UI 7.7 to 9.2), whereas that of SCI did not change significantly (-0.2% [-2.1 to 2.7]). Age-standardised incidence rates increased by 3.6% (1.8 to 5.5) for TBI, but did not change significantly for SCI (-3.6% [-7.4 to 4.0]). TBI caused 8.1 million (95% UI 6. 0-10. 4 million) YLDs and SCI caused 9.5 million (6.7-12.4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions.
Interpretation TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.
Details
- Title: Subtitle
- Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
- Creators
- Spencer L. James - University of WashingtonAlice Theadom - Auckland University of TechnologyRichard G. Ellenbogen - University of GroningenMarlena S. Bannick - University of WashingtonW. Cliff Mountjoy-Venning - University of WashingtonLydia R. Lucchesi - Institute for Health Metrics and EvaluationNooshin Abbasi - Institute for Health Metrics and EvaluationRizwan Abdulkader - Institute for Health Metrics and EvaluationHaftom Niguse Abraha - University of WashingtonJose C. Adsuar - University of GroningenMohsen Afarideh - University of GroningenSutapa Agrawal - Institute for Health Metrics and EvaluationAlireza Ahmadi - Institute for Health Metrics and EvaluationMuktar Beshir Ahmed - University of GroningenAmani Nidhal Aichour - Institute for Health Metrics and EvaluationIbtihel Aichour - Institute for Health Metrics and EvaluationMiloud Taki Eddine Aichour - Institute for Health Metrics and EvaluationRufus Olusola Akinyemi - University of GroningenNadia Akseer - Institute for Health Metrics and EvaluationFares Alahdab - Auckland University of TechnologyAnimut Alebel - Institute for Health Metrics and EvaluationSuliman A. Alghnam - University of GroningenBeriwan Abdulqadir Ali - Auckland University of TechnologyUbai Alsharif - University of GroningenKhalid Altirkawi - Institute for Health Metrics and EvaluationCatalina Liliana Andrei - Institute for Health Metrics and EvaluationMina Anjomshoa - Institute for Health Metrics and EvaluationHossein Ansari - Institute for Health Metrics and EvaluationMustafa Geleto Ansha - Institute for Health Metrics and EvaluationCarl Abelardo T. Antonio - Institute for Health Metrics and EvaluationSeth Christopher Yaw Appiah - University of GroningenFilippo Ariani - University of GroningenNigus Gebremedhin Asefa - University of GroningenSolomon Weldegebreal Asgedom - Institute for Health Metrics and EvaluationSuleman Atique - University of GroningenAshish Awasthi - Institute for Health Metrics and EvaluationBeatriz Paulina Ayala Quintanilla - University of GroningenTambe B. Ayuk - Ctr Food & Nutr Res, Inst Med Res & Med Plant studies, Yaounde, CameroonPeter S. Azzopardi - Institute for Health Metrics and EvaluationHamid Badali - Institute for Health Metrics and EvaluationAlaa Badawi - Institute for Health Metrics and EvaluationShivanthi Balalla - University of GroningenAmrit Banstola - University of WashingtonSuzanne Lyn Barker-Collo - Institute for Health Metrics and EvaluationTill Winfried Barnighausen - Institute for Health Metrics and EvaluationNeeraj Bedi - Institute for Health Metrics and EvaluationMasoud Behzadifar - University of WashingtonMeysam Behzadifar - University of GroningenBayu Begashaw Bekele - University of GroningenAbate Bekele Belachew - Institute for Health Metrics and EvaluationYihalem Abebe Belay - Institute for Health Metrics and EvaluationDerrick A. Bennett - Institute for Health Metrics and EvaluationIsabela M. Bensenor - Institute for Health Metrics and EvaluationAdugnaw Berhane - Institute for Health Metrics and EvaluationMircea Beuran - Institute for Health Metrics and EvaluationAshish Bhalla - University of GroningenSoumyadeeep Bhaumik - The George Institute for Global HealthZulfiqar A. Bhutta - Institute for Health Metrics and EvaluationBelete Biadgo - Auckland University of TechnologyMarco Biffino - University of GroningenAli Bijani - Auckland University of TechnologyNigus Bililign - University of GroningenCharles Birungi - Institute for Health Metrics and EvaluationSoufiane Boufous - Institute for Health Metrics and EvaluationAlexandra Brazinova - University of WashingtonAllen W. Brown - University of WashingtonMate Car - University of GroningenRosario Cardenas - Institute for Health Metrics and EvaluationJuan J. Carrero - Karolinska InstitutetFelix Carvalho - University of GroningenCarlos A. Castaneda-Orjuela - University of GroningenFerran Catala-Lopez - University of GroningenYazan Chaiah - Institute for Health Metrics and EvaluationAna Paula Champs - Institute for Health Metrics and EvaluationJung-Chen Chang - Natl Taiwan Univ, Coll Med, Taipei, TaiwanJee-Young J. Choi - University of GroningenDevasahayam J. Christopher - University of GroningenCyrus Cooper - University of GroningenChristopher Stephen Crowe - University of GroningenLalit Dandona - University of WashingtonRakhi Dandona - University of GroningenAhmad Daryani - University of GroningenDragos Virgil Davitoiu - Carol Davila Univ Med & Pharm, Dept Gen Surg, Bucharest, RomaniaMeaza Girma Degefa - University of GroningenGebre Teklemariam Demoz - University of GroningenKebede Deribe - University of GroningenShirin Djalalinia - Auckland University of TechnologyHuyen Phuc Do - Duy Tan UniversityDavid Teye Doku - University of GroningenThomas M. Drake - University of GroningenManisha Dubey - University of GroningenEleonora Dubljanin - University of GroningenZiad El-Khatib - University of GroningenSharareh Eskandarieh - Auckland University of TechnologyAlireza Esteghamati - University of GroningenSadaf Esteghamati - University of GroningenAndre Faro - Auckland University of TechnologyFarshad Farzadfar - University of GroningenMohammad Hosein Farzaei - Auckland University of TechnologySeyed-Mohammad Fereshtehnejad - McGill UniversityGBD 2016 Traumatic Brain Injury and Spinal Cord Injury CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- Lancet neurology, Vol.18(1), pp.56-87
- DOI
- 10.1016/S1474-4422(18)30415-0
- PMID
- 30497965
- PMCID
- PMC6291456
- NLM abbreviation
- Lancet Neurol
- ISSN
- 1474-4422
- eISSN
- 1474-4465
- Publisher
- Elsevier
- Number of pages
- 32
- Grant note
- Bill & Melinda Gates Foundation; Bill & Melinda Gates Foundation Grand Challenges Explorations Initiative; CGIAR MC_U147585819 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC)
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Research Administration
- Record Identifier
- 9984949192602771
Metrics
7 Record Views