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, Islam, S M Shariful, Stokes, M A and Rahman, M A 2019, 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, Lancet: neurology, vol. 18, no. 1, pp. 56-87, doi: 10.1016/S1474-4422(18)30415-0.

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Title 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
Author(s) GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators
Islam, S M SharifulORCID iD for Islam, S M Shariful orcid.org/0000-0001-7926-9368
Stokes, M AORCID iD for Stokes, M A orcid.org/0000-0001-6488-4544
Rahman, M AORCID iD for Rahman, M A orcid.org/0000-0002-8162-8945
Journal name Lancet: neurology
Volume number 18
Issue number 1
Start page 56
End page 87
Total pages 30
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2019-01
ISSN 1474-4465
Keyword(s) GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences & Neurology
UNITED-STATES
NEW-ZEALAND
EPIDEMIOLOGY
SURVIVAL
Summary 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.
Notes Collaborators listed at the end of the Article
Language eng
DOI 10.1016/S1474-4422(18)30415-0
Field of Research 1103 Clinical Sciences
1109 Neurosciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30116273

Document type: Journal Article
Collections: School of Psychology
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