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
Spencer L James(University of Groningen), Alice Theadom(University of Groningen), Richard G. Ellenbogen(University of Groningen), Marlena S. Bannick(University of Groningen), Wcliff Montjoy-Venning, Lydia R Lucchesi(University of Groningen), Nooshin Abbasi(University of Groningen), Rizwan Suliankatchi Abdulkader(University of Washington), Haftom Niguse Abraha(University of Groningen), José Carmelo Adsuar(University of Groningen), Mohsen Afarideh(University of Groningen), Sutapa Agrawal(University of Groningen), Alireza Ahmadi(University of Groningen), Muktar Beshir Ahmed(University of Groningen), Amani Nidhal Aichour(University of Groningen), Ibtihel Aichour(University of Groningen), Miloud Taki Eddine Aichour(University of Groningen), Rufus Akinyemi(University of Groningen), Nadia Akseer(University of Groningen), Fares Alahdab(University of Groningen), Animut Alebel(University of Groningen), Suliman Alghnam(University of Groningen), Beriwan Abdulqadir Ali(University of Groningen), Ubai Alsharif(University of Groningen), Khalid A Altirkawi(University of Groningen), Cătălina Liliana Andrei(University of Groningen), Mina Anjomshoa(University of Groningen), Hossein Ansari(University of Groningen), Mustafa Geleto Ansha(University of Groningen), Carl Abelardo T. Antonio(University of Groningen), Seth Christopher Yaw Appiah(University of Groningen), Filippo Ariani(University of Groningen), Nigus Gebremedhin Asefa(University of Groningen), Solomon Weldegebreal Asgedom(University of Groningen), Suleman Atique(University of Groningen), Ashish Awasthi(University of Groningen), Beatriz Paulina Ayala Quintanilla(University of Groningen), Ayuk Betrand Tambe(University of Groningen), Peter Azzopardi(University of Groningen), Hamid Badali(University of Groningen), Alaa Badawi(University of Groningen), Shivanthi Balalla(University of Groningen), Amrit Banstola(University of Groningen), Suzanne Barker‐Collo(University of Groningen), Till Bärnighausen(University of Groningen), Neeraj Bedi(University of Groningen), Masoud Behzadifar(University of Groningen), Meysam Behzadifar(University of Groningen), Bayu Begashaw Bekele(University of Groningen), Abate Bekele Belachew(University of Groningen), Yihalem Abebe Belay(University of Groningen), Derrick Bennett(University of Groningen), Isabela M. Benseñor(University of Groningen), Adugnaw Berhane(University of Groningen), Mircea Beuran(University of Groningen), Ashish Bhalla(University of Groningen), Soumyadeeep Bhaumik(University of Groningen), Zulfiqar A Bhutta(University of Groningen), Belete Biadgo(University of Groningen), Marco Biffino(University of Groningen), Ali Bijani(University of Groningen), Nigus Bililign(University of Groningen), Charles Birungi(University of Groningen), Soufiane Boufous(University of Groningen), Alexandra Bražinová(University of Groningen), Allen W. Brown(University of Groningen), Mate Car(University of Groningen), Rosario Cárdenas(University of Groningen), Juan Jesús Carrero(University of Groningen), Félix Carvalho(University of Groningen), Carlos A Castañeda-Orjuela(University of Groningen), Ferrán Catalá-López(University of Groningen), Yazan Chaiah(University of Groningen), Ana Paula Silva Champs(University of Groningen), Jung‐Chen Chang(University of Groningen), Jee-Young Jasmine Choi(University of Groningen), Devasahayam Jesudas Christopher(University of Groningen), Cyrus Cooper(University of Groningen), Christopher S. Crowe(University of Groningen), Lalit Dandona(University of Groningen), Rakhi Dandona(University of Groningen), Ahmad Daryani(University of Groningen), Dragoş Virgil Daviţoiu, Meaza Girma Degefa(University of Groningen), Gebre Teklemariam Demoz(University of Groningen), Kebede Deribe(University of Groningen), Shirin Djalalinia(University of Groningen), Huyen Phuc(University of Groningen), David Teye Doku(University of Groningen), Thomas M Drake(University of Groningen), Manisha Dubey(University of Groningen), Eleonora Dubljanin(University of Groningen), Ziad El‐Khatib(University of Groningen), Richard Ofori‐Asenso(University of Groningen), Sharareh Eskandarieh(University of Groningen), Alireza Esteghamati(University of Groningen), Sadaf Esteghamati(University of Groningen), André Faro(University of Groningen), Farshad Farzadfar(University of Groningen), Mohammad Hosein Farzaei(University of Groningen), Seyed‐Mohammad Fereshtehnejad(University of Groningen), Eduarda Fernandes(University of Groningen), Garumma Tolu Feyissa(University of Groningen), Irina Filip(University of Groningen), Florian Fischer(University of Groningen), Takeshi Fukumoto(University of Groningen), Morasaleh Ganji(University of Groningen), Fortuné Gbètoho Gankpé(University of Groningen), Abadi Kahsu Gebre(University of Groningen), Tsegaye Tewelde Gebrehiwot, Kebede Embaye Gezae(University of Groningen), Gururaj Gopalkrishna(University of Groningen), Alessandra C. Goulart(University of Groningen), Juanita A. Haagsma(University of Groningen), Arvin Haj‐Mirzaian(University of Groningen), Arya Haj‐Mirzaian(University of Groningen), Randah R Hamadeh(University of Groningen), Samer Hamidi(University of Groningen), Josep María Haro(University of Groningen), Hadi Hassankhani(University of Groningen), Hamid Yimam Hassen(University of Groningen), Rasmus Havmoeller(University of Groningen), Caitlin Hawley(University of Groningen), Simon I Hay(University of Groningen), Mohamed Hegazy(University of Groningen), Delia Hendrie(University of Groningen), Andualem Henok(University of Groningen), Desalegn Tsegaw Hibstu(University of Groningen), Howard J. Hoffman(University of Groningen), Michael K. Hole(University of Groningen), Enayatollah Homaie Rad, Seyed Mostafa Hosseini(University of Groningen), Sorin Hostiuc(University of Groningen), Guoqing Hu(University of Groningen), Mamusha Aman Hussen, Olayinka Stephen Ilesanmi(University of Groningen), Seyed Sina Naghibi Irvani(University of Groningen), Mihajlo Jakovljević(University of Groningen), Sudha Jayaraman(University of Groningen), Ravi Prakash Jha(University of Groningen), Jost B. Jonas(University of Groningen), Kelly Jones(University of Groningen), Zahra Jorjoran Shushtari(University of Groningen), Jacek Jerzy Jozwiak(University of Groningen), Mikk Jürisson(University of Groningen), Ali Kabir(University of Groningen), Amaha Kahsay(University of Groningen), Molla Kahssay(University of Groningen), Rizwan Kalani(University of Groningen), André Karch(University of Groningen), Amir Kasaeian(University of Groningen), Getachew Mullu Kassa(University of Groningen), Tesfaye Kassa(University of Groningen), Zemenu Yohannes Kassa(University of Groningen), André Pascal Kengne(University of Groningen), Yousef Khader(University of Groningen), Morteza Abdullatif Khafaie(University of Groningen), Nauman Khalid(University of Groningen), Ibrahim Khalil(University of Groningen), Ejaz Ahmad Khan(University of Groningen), Muhammad Shahzeb Khan(University of Groningen), Young‐Ho Khang(University of Groningen), Habibolah Khazaie(University of Groningen), Abdullah T Khoja(University of Groningen), Jagdish Khubchandani(University of Groningen), Ali Kiadaliri(University of Groningen), Daniel Kim(University of Groningen), Young‐Eun Kim(University of Groningen), Adnan Kısa(University of Groningen), Ai Koyanagi(University of Groningen), Kristopher J Krohn, Barthélémy Kuate Defo(University of Groningen), Burcu Küçük Biçer(University of Groningen), G Anil Kumar(University of Groningen), Manasi Kumar(University of Groningen), Ratilal Lalloo(University of Groningen), Faris Lami(University of Groningen), Van Charles Lansingh(University of Groningen), Dennis Odai Laryea(University of Groningen), Arman Latifi(University of Groningen), Cheru Tesema Leshargie(University of Groningen), Miriam Levi(University of Groningen), Shanshan Li(University of Groningen), Misgan Legesse Liben(University of Groningen), Paulo A. Lotufo(University of Groningen), Raimundas Lunevičius(University of Groningen), Narayan Bahadur Mahotra(University of Groningen), Marek Majdán(University of Groningen), Azeem Majeed(University of Groningen), Reza Malekzadeh(University of Groningen), Ana-Laura Manda(University of Groningen), Mohammad Alì Mansournia(University of Groningen), Benjamin B. Massenburg(University of Groningen), Kedar Mate, Man Mohan Mehndiratta(University of Groningen), Varshil Mehta(University of Groningen), Hagazi Gebre Meles(University of Groningen), Addisu Melese(University of Groningen), Peter Memiah(University of Groningen), Walter Mendoza(University of Groningen), Getnet Mengistu(University of Groningen), Atte Meretoja(University of Groningen), Tuomo J Meretoja(University of Groningen), Tomislav Meštrović(University of Groningen), Tomasz Miazgowski(University of Groningen), Ted R. Miller(University of Groningen), GK Mini(University of Groningen), Andreea Mirică(University of Groningen), Erkin М Мirrakhimov(University of Groningen), Babak Moazen(University of Groningen), Moslem Mohammadi(University of Groningen), Shafiu Mohammed(University of Groningen), Ali H. Mokdad(University of Groningen), Mariam Molokhia(University of Groningen), Lorenzo Monasta(University of Groningen), Stefania Mondello(University of Groningen), Mahmood Moosazadeh(University of Groningen), Ghobad Moradi(University of Groningen), Mahmoudreza Moradi(University of Groningen), Maziar Moradi‐Lakeh(University of Groningen), Mehdi Moradinazar(University of Groningen), Shane D. Morrison(University of Groningen), Marilita M. Moschos(University of Groningen), Seyyed Meysam Mousavi(University of Groningen), Srinivas Murthy(University of Groningen), Kamarul Imran Musa(University of Groningen), Ghulam Mustafa(University of Groningen), Mohsen Naghavi(University of Groningen), Gurudatta Naik(University of Groningen), Farid Najafi(University of Groningen), Vinay Nangia(University of Groningen), Bruno Ramos Nascimento(University of Groningen), Ionuţ Negoi(University of Groningen), Trang Huyen Nguyen(University of Groningen), Emma Nichols(University of Groningen), Dina Nur Anggraini Ningrum(University of Groningen), Yirga Legesse Nirayo(University of Groningen), Peter S. Nyasulu(University of Groningen), Felix Akpojene Ogbo(University of Groningen), In‐Hwan Oh(University of Groningen), Anselm Okoro(University of Groningen), Andrew T Olagunju(University of Groningen), Tinuke O Olagunju(University of Groningen), Pedro R. Olivares(University of Groningen), Stanislav S Otstavnov(University of Groningen), Mayowa Owolabi(University of Groningen), P A Mahesh(University of Groningen), Smita Pakhalé(University of Groningen), Achyut Raj Pandey(University of Groningen), Konrad Pesudovs(University of Groningen), Gabriel David Pinilla-Monsalve(University of Groningen), Suzanne Polinder(University of Groningen), Hossein Poustchi(University of Groningen), Swayam Prakash(University of Groningen), Mostafa Qorbani(University of Groningen), Amir Radfar(University of Groningen), Anwar Rafay(University of Groningen), Alireza Rafiei(University of Groningen), Afarin Rahimi‐Movaghar(University of Groningen), Vafa Rahimi‐Movaghar(University of Groningen), Mahfuzar Rahman(University of Groningen), Muhammad Aziz Rahman(University of Groningen), Rajesh Kumar(University of Groningen), Fatemeh Rajati(University of Groningen), Usha Ram(University of Groningen), David Laith Rawaf(University of Groningen), Salman Rawaf(University of Groningen), Robert C. Reiner(University of Groningen), Cesar Reis(University of Groningen), André M. N. Renzaho(University of Groningen), Serge Resnikoff(University of Groningen), Satar Rezaei(University of Groningen), Shahab Rezaeian(University of Groningen), Leonardo Roever(University of Groningen), Luca Ronfani(University of Groningen), Gholamreza Roshandel(University of Groningen), Nobhojit Roy(University of Groningen), George Mugambage Ruhago(University of Groningen), Basema Saddik(University of Groningen), Hosein Safari(University of Groningen), Saeid Safiri(University of Groningen), Mohammad Ali Sahraian(University of Groningen), Payman Salamati(University of Groningen), Raphael de Freitas Saldanha(University of Groningen), Abdallah M Samy(University of Groningen), Juan Sanabria(University of Groningen), João Vasco Santos(University of Groningen), Milena M Santric-Milicevic(University of Groningen), Benn Sartorius(University of Groningen), Maheswar Satpathy(University of Groningen), Savuon Kim(University of Groningen), Ione Jayce Ceola Schneider(University of Groningen), David C. Schwebel(University of Groningen), Sadaf G Sepanlou(University of Groningen), Hosein Shabaninejad(University of Groningen), Masood Ali Shaikh(University of Groningen), Mehran Shams-Beyranvand(University of Groningen), Mehdi Sharif(University of Groningen), Mahdi Sharif-Alhoseini, Sheikh Mohammed Shariful Islam, Jun She(University of Groningen), Aziz Sheikh(University of Groningen), Jiabin Shen(University of Groningen), Kevin N. Sheth(University of Groningen), Kenji Shibuya(University of Groningen), Mekonnen Sisay Shiferaw(University of Groningen), Mika Shigematsu(University of Groningen), Rahman Shiri(University of Groningen), Ivy Shiue(University of Groningen), Haitham Shoman(University of Groningen), Soraya Siabani(University of Groningen), Tariq Jamal Siddiqi(University of Groningen), João Pedro Silva(University of Groningen), Dayane Gabriele Alves Silveira, Dhirendra Narain Sinha(University of Groningen), Mari Smith(University of Groningen), Adauto Martins Soares Filho, Soheila Sobhani(University of Groningen), Moslem Soofi(University of Groningen), Joan B. Soriano(University of Groningen), Ireneous N Soyiri(University of Groningen), Dan J. Stein(University of Groningen), Mark A. Stokes(University of Groningen), Mu’awiyyah Babale Sufiyan(University of Groningen), Bruno Sunguya(University of Groningen), Jacob E. Sunshine(University of Groningen), Bryan L. Sykes(University of Groningen), Cassandra Szoeke(University of Groningen), Rafael Tabarés‐Seisdedos(University of Groningen), Braden Te Ao, Arash Tehrani‐Banihashemi(University of Groningen), Merhawi Gebremedhin Tekle(University of Groningen), Mohamad‐Hani Temsah(University of Groningen), Omar Temsah(University of Groningen), Roman Topór-Mądry(University of Groningen), Miguel Tortajada‐Girbés(University of Groningen), Bach Xuan Tran(University of Groningen), Khanh Bao Tran(University of Groningen), Lorainne Tudor Car, Kingsley Nnanna Ukwaja(University of Groningen), Irfan Ullah(University of Groningen), Muhammad Usman(University of Groningen), Olalekan A. Uthman(University of Groningen), Pascual Valdéz(University of Groningen), Tommi Vasankari(University of Groningen), Narayanaswamy Venketasubramanian(University of Groningen), Francesco Saverio Violante, Fasil Wagnew(University of Groningen), Yasir Waheed(University of Groningen), Yuan‐Pang Wang(University of Groningen), Kidu Gidey Weldegwergs(University of Groningen), Andrea Werdecker(University of Groningen), Tissa Wijeratne(University of Groningen), Andrea Sylvia Winkler(University of Groningen), Grant M. A. Wyper(University of Groningen), Yuichiro Yano(University of Groningen), Mehdi Yaseri(University of Groningen), Yasin Jemal Yasin(University of Groningen), Pengpeng Ye(University of Groningen), Ebrahim M Yimer(University of Groningen), Paul Yip(University of Groningen), Engida Yisma(University of Groningen), Naohiro Yonemoto(University of Groningen), Seok‐Jun Yoon(University of Groningen), Michael G. Yost(University of Groningen), Mustafa Z Younis(University of Groningen), Mahmoud Yousefifard(University of Groningen), Chuanhua Yu(University of Groningen), Zoubida Zaidi(University of Groningen), Sojib Bin Zaman(University of Groningen), Mohammad Zamani(University of Groningen), Zerihun Menlkalew Zenebe(University of Groningen), Sanjay Zodpey(University of Groningen), Valery L. Feigin(University of Groningen), Theo Vos(University of Groningen), Christopher J L Murray
Cited by 1,968Open Access
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. FUNDING: Bill & Melinda Gates Foundation.
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