Trends and levels of the global, regional, and national burden of injuries from 1990 to 2021: findings from the global burden of disease study 2021

1990年至2021年全球、区域和国家伤害负担的趋势和水平:2021年全球疾病负担研究的发现

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Abstract

BACKGROUND/OBJECTIVES: Injuries remain a major global public health challenge. This study aimed to analyze the global, regional, and national burden of injuries from 1990 to 2021 and project future trends to 2046, addressing a gap in long-term trend analyses and projections accounting for demographic shifts. PATIENTS/MATERIALS AND METHODS: We conducted an observational analysis using data from the Global Burden of Disease (GBD) Study 2021, covering 204 countries and territories. We extracted data on injury incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates (ASRs) were calculated. Temporal trends (1990-2021) were assessed using estimated annual percentage change (EAPC). Future burden (2022-2046) was projected using statistical modeling. RESULTS: Globally, while absolute numbers of injury incidence, prevalence, deaths, and DALYs increased from 1990 to 2021, all corresponding ASRs declined significantly (EAPC: incidence - 0.96%, prevalence - 0.73%, mortality - 1.55%, and DALYs - 1.75%). Males consistently bore a greater burden than females (mortality ratio male:female = 2.41). Marked disparities existed: mortality rates in low Socio-demographic Index (SDI) regions were 2.5 times higher than in high SDI regions. Afghanistan, the Central African Republic, and Lesotho had the highest national mortality rates; Singapore, Spain, and Italy the lowest. Projections indicate rising absolute cases but declining ASRs through 2046. CONCLUSION: Despite declining ASRs, the increasing absolute injury burden necessitates intensified prevention efforts. Targeted interventions are crucial to address persistent geographic, demographic (especially males), and socioeconomic (low SDI regions) disparities.

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