Abstract
Pressure ulcers (PUs) are chronic wounds that pose a significant burden on patients, families, and healthcare systems worldwide. This study evaluates the prevalence, trends, and burden of PUs to inform targeted public health policies. Using data from the Global Burden of Disease (GBD) Study 2021, we analysed PU incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries from 1990 to 2021. Trends were assessed using the estimated annual percentage change (EAPC) in age-standardised rates (ASRs), and future projections were made using the ARIMA model. Globally, PU incident cases increased from 1,142,594.8 in 1990 to 2,468,317.5 in 2021. The ASIR showed a slight decrease, from 31.5 to 30.3 per 100,000. The mortality rose from 16,741.1 to 37,032.7, while the ASMR exhibited numerical stability (0.5 per 100,000). The DALYs increased from 408,887.0 in 1990 to 803,747.4 in 2021, with a decline in ASDR, from 10.7 to 9.7 per 100,000. Absolute numbers, ASRs, and EAPCs exhibit a pronounced correlation with the SDI. Moreover, there exist notable disparities across different regions or nations. The burden of PU was notably higher in elderly females, though the increase among the elderly males was also significant. Projections for 2022-2031 indicate a slight decrease in both ASIR and ASMR, while ASDR is expected to rise. While PU incidence remains high, disparities persist, especially in low-SDI regions. Strengthening prevention strategies and improving healthcare access are critical to reducing the global PU burden.