Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 6;13(10):e075049.
doi: 10.1136/bmjopen-2023-075049.

Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Bin Guan #  1 , David B Anderson #  2 , Lingxiao Chen  3   4 , Shiqing Feng  3   5 , Hengxing Zhou  3   6
Affiliations

Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Bin Guan et al. BMJ Open. .

Abstract

Objectives: To evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories.

Design: An analysis of Global Burden of Disease (GBD) data.

Setting: The epidemiological data were gathered from GBD Results Tool (1 January, 1990─31 December 2019) covering 21 GBD regions and 204 countries/ territories.

Participants: Patients with TBI/SCI.

Main outcomes and measures: Absolute numbers and age-standardised rates/estimates of incidence, prevalence and years lived with disability (YLDs) of TBI/SCI by location in 2019, with their percentage changes from 1990 to 2019. The leading causes (eg, falls) of TBI/SCI in 204 countries/territories.

Results: Globally, in 2019, TBI had 27.16 million new cases, 48.99 million prevalent cases and 7.08 million YLDs. SCI had 0.91 million new cases, 20.64 million prevalent cases and 6.20 million YLDs. Global age-standardised incidence rates of TBI decreased significantly by -5.5% (95% uncertainty interval -8.9% to -3.0%) from 1990 to 2019, whereas SCI had no significant change (-6.1% (-17.3% to 1.5%)). Regionally, in 2019, Eastern Europe and High-income North America had the highest burden of TBI and SCI, respectively. Nationally, in 2019, Slovenia and Afghanistan had the highest age-standardised incidence rates of TBI and SCI, respectively. For TBI, falls were the leading cause in 74% (150/204) of countries/territories, followed by pedestrian road injuries (14%, 29/204), motor vehicle road injuries (5%, 11/204), and conflict and terrorism (2%, 4/204). For SCI, falls were the leading cause in 97% (198/204) of countries/territories, followed by conflict and terrorism (3%, 6/204).

Conclusions: Global age-standardised incidence rates of TBI have decreased significantly since 1990, whereas SCI had no significant change. The leading causes of TBI/SCI globally were falls, but variations did exist between countries/territories. Policy-makers should continue to prioritise interventions to reduce falls, but priorities may vary between countries/territories.

Keywords: epidemiology; neurology; orthopaedic & trauma surgery; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Age-standardised incidence rates per 100 000 persons of traumatic brain injury (A) and spinal cord injury (B) by countries/territories, 2019.
Figure 2
Figure 2
The leading causes for age-standardised incidence rates of traumatic brain injury (A) and spinal cord injury (B) by countries/territories, 2019
Figure 3
Figure 3
Number of countries/territories by the leading causes for age-standardised incidence rates of traumatic brain injury (TBI) (A) and spinal cord injury (SCI) (B); total countries/territories=204; the listed are the top three countries/territories with age-standardised incidence rates caused by each cause, 2019; and the top three with both the largest increase and the largest decrease, 1990–2019.
See this image and copyright information in PMC

References

    1. Maas AIR, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol 2008;7:728–41. 10.1016/S1474-4422(08)70164-9 Available: 10.1016/s1474-4422(08)70164-9 - DOI - DOI - PubMed
    1. Ahuja CS, Wilson JR, Nori S, et al. Traumatic spinal cord injury. Nat Rev Dis Primers 2017;3:17018. 10.1038/nrdp.2017.18 Available: 10.1038/nrdp.2017.18 - DOI - DOI - PubMed
    1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the global burden of disease study 2016. The Lancet 2017;390:1211–59. 10.1016/S0140-6736(17)32154-2 Available: 10.1016/s0140-6736(17)32154-2 - DOI - DOI - PMC - PubMed
    1. GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators . 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. The Lancet Neurology 2019;18:56–87. 10.1016/S1474-4422(18)30415-0 Available: 10.1016/s1474-4422(18)30415-0 - DOI - DOI - PMC - PubMed
    1. GBD 2019 Diseases and Injuries Collaborators . Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. The Lancet 2020;396:1204–22. 10.1016/S0140-6736(20)30925-9 Available: 10.1016/s0140-6736(20)30925-9 - DOI - DOI - PMC - PubMed

Publication types