Abstract
BACKGROUND AND AIMS: Decubitus ulcers represent a significant public health challenge in China, yet their disease burden remains understudied in the peer-reviewed literature. This study aims to fill this critical gap by comprehensively analyzing the incidence, mortality, and disability-adjusted life years (DALYs) trends of decubitus ulcers in China to inform effective healthcare planning. METHODS: We analyzed the burden of decubitus ulcers in China from 1990 to 2021 using data from the Global Burden of Disease Study 2021, focusing on the incidence, mortality, and DALYs. The disease burden's long-term trends were evaluated using joinpoint regression and age-period-cohort models, and its future trajectory from 2022 to 2036 was forecast with an Autoregressive Integrated Moving Average (ARIMA) model. RESULTS: From 1990 to 2021, China's age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) of decubitus ulcers increased by 23.85%, 162.50%, and 108.57%, respectively, with the heaviest burden seen in men and those aged 65 and over. Joinpoint regression analysis indicated annual average percentage changes (AAPCs) of 0.68% for ASIR, 3.16% for ASMR, and 2.38% for ASDR. Period effects on incidence initially decreased but subsequently increased, whereas mortality and DALYs displayed an opposite trend. Cohort analysis revealed a decline in incidence among cohorts born after 1942-1946; however, mortality and DALYs rates showed a consistent upward trend across all cohorts. By 2036, ASIR is projected to decrease by 6.7% in males and by 2.0% in females, while ASMR and ASDR are anticipated to rise by more than 25% in both sexes. CONCLUSIONS: China has experienced a significant increase in the burden of decubitus ulcers from 1990 to 2021, with the elderly and males being disproportionately affected. This underscores the urgent need for targeted, gender- and age-specific interventions to mitigate the escalating burden of decubitus ulcers.