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

GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators

Research output: Contribution to journalArticle

22 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)56-87
Number of pages32
JournalThe Lancet Neurology
Volume18
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

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Spinal Cord Injuries
Wounds and Injuries
Incidence
Uncertainty
Global Burden of Disease
Traumatic Brain Injury
Motorcycles
Health Priorities
Mortality
Population Growth
Motor Vehicles
Population Density
Population
Fertility
Inpatients

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

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. / GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators.

In: The Lancet Neurology, Vol. 18, No. 1, 01.01.2019, p. 56-87.

Research output: Contribution to journalArticle

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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.",
author = "{GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators} and James, {Spencer L.} and Alice Theadom and Ellenbogen, {Richard G.} and Bannick, {Marlena S.} and Wcliff Montjoy-Venning and Lucchesi, {Lydia R.} and Nooshin Abbasi and Rizwan Abdulkader and Abraha, {Haftom Niguse} and Adsuar, {Jose C.} and Mohsen Afarideh and Sutapa Agrawal and Alireza Ahmadi and Ahmed, {Muktar Beshir} and Aichour, {Amani Nidhal} and Ibtihel Aichour and Aichour, {Miloud Taki Eddine} and Akinyemi, {Rufus Olusola} and Nadia Akseer and Fares Alahdab and Animut Alebel and Alghnam, {Suliman A.} and Ali, {Beriwan Abdulqadir} and Ubai Alsharif and Khalid Altirkawi and Andrei, {Catalina Liliana} and Mina Anjomshoa and Hossein Ansari and Ansha, {Mustafa Geleto} and Antonio, {Carl Abelardo T.} and Appiah, {Seth Christopher Yaw} and Filippo Ariani and Asefa, {Nigus Gebremedhin} and Asgedom, {Solomon Weldegebreal} and Suleman Atique and Ashish Awasthi and {Ayala Quintanilla}, {Beatriz Paulina} and Ayuk, {Tambe B.} and Azzopardi, {Peter S.} and Hamid Badali and Alaa Badawi and Shivanthi Balalla and Amrit Banstola and Barker-Collo, {Suzanne Lyn} and B{\"a}rnighausen, {Till Winfried} and Neeraj Bedi and Masoud Behzadifar and Meysam Behzadifar and Bekele, {Bayu Begashaw} and Seok-Jun Yoon",
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TY - JOUR

T1 - Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016

T2 - a systematic analysis for the Global Burden of Disease Study 2016

AU - GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators

AU - James, Spencer L.

AU - Theadom, Alice

AU - Ellenbogen, Richard G.

AU - Bannick, Marlena S.

AU - Montjoy-Venning, Wcliff

AU - Lucchesi, Lydia R.

AU - Abbasi, Nooshin

AU - Abdulkader, Rizwan

AU - Abraha, Haftom Niguse

AU - Adsuar, Jose C.

AU - Afarideh, Mohsen

AU - Agrawal, Sutapa

AU - Ahmadi, Alireza

AU - Ahmed, Muktar Beshir

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Aichour, Miloud Taki Eddine

AU - Akinyemi, Rufus Olusola

AU - Akseer, Nadia

AU - Alahdab, Fares

AU - Alebel, Animut

AU - Alghnam, Suliman A.

AU - Ali, Beriwan Abdulqadir

AU - Alsharif, Ubai

AU - Altirkawi, Khalid

AU - Andrei, Catalina Liliana

AU - Anjomshoa, Mina

AU - Ansari, Hossein

AU - Ansha, Mustafa Geleto

AU - Antonio, Carl Abelardo T.

AU - Appiah, Seth Christopher Yaw

AU - Ariani, Filippo

AU - Asefa, Nigus Gebremedhin

AU - Asgedom, Solomon Weldegebreal

AU - Atique, Suleman

AU - Awasthi, Ashish

AU - Ayala Quintanilla, Beatriz Paulina

AU - Ayuk, Tambe B.

AU - Azzopardi, Peter S.

AU - Badali, Hamid

AU - Badawi, Alaa

AU - Balalla, Shivanthi

AU - Banstola, Amrit

AU - Barker-Collo, Suzanne Lyn

AU - Bärnighausen, Till Winfried

AU - Bedi, Neeraj

AU - Behzadifar, Masoud

AU - Behzadifar, Meysam

AU - Bekele, Bayu Begashaw

AU - Yoon, Seok-Jun

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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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