A systematic analysis on global epidemiology and burden of foot fracture over three decades

Abstract

Purpose: To comprehensively analyze the geographic and temporal trends of foot fracture, understand its health burden by age, sex, and sociodemographic index (SDI), and explore its leading causes from 1990 to 2019.

Methods: The datasets in the present study were generated from the Global Burden of Diseases Study 2019, which included foot fracture data from 1990 to 2019. We extracted estimates along with the 95% uncertainty interval (UI) for the incidence and years lived with disability (YLDs) of foot fracture by location, age, gender, and cause. The epidemiology and burden of foot fracture at the global, regional, and national level was exhibited. Next, we presented the age and sex patterns of foot fracture. The leading cause of foot fracture was another focus of this study from the viewpoint of age, sex, and location. Then, Pearson's correlations between age-standardized rate (ASR), SDI, and estimated annual percentage change were calculated.

Results: The age-standardized incidence rate was 138.68 (95% UI: 104.88 - 182.53) per 100,000 persons for both sexes, 174.24 (95% UI: 134.35 - 222.49) per 100,000 persons for males, and 102.19 (95% UI: 73.28 - 138.00) per 100,000 persons for females in 2019. The age-standardized YLDs rate was 5.91 (95% UI: 3.58 - 9.25) per 100,000 persons for both genders, 7.35 (95% UI: 4.45 - 11.50) per 100,000 persons for males, and 4.51 (95% UI: 2.75 - 7.03) per 100,000 persons for females in 2019. The global incidence and YLDs of foot fracture increased in number and decreased in ASR from 1990 to 2019. The global geographical distribution of foot fracture is uneven. The incidence rate for males peaked at the age group of 20 - 24 years, while that for females increased with advancing age. The incidence rate of older people was rising, as younger age incidence rate declined from 1990 to 2019. Falls, exposure to mechanical forces, and road traffic injuries were the 3 leading causes of foot fracture. Correlations were observed between ASR, estimated annual percentage change, and SDI.

Conclusions: The burden of foot fracture remains high globally, and it poses an enormous public health challenge, with population aging. It is necessary to allocate more resources to the high-risk populations. Targeted realistic intervention policies and strategies are warranted.

Keywords: Epidemiology; Foot fracture; Global burden of disease; Incidence; Years lived with disability.

Fig. 1

(A) Global trends of incidence and (B) YLDs rate of foot fracture by sex from 1990 to 2019. The bar graphs represent the crude rate, corresponding to vertical ordinate at left. The line graphs represent the age-standardized rate, corresponding to vertical ordinate at right. CIR: crude incidence rate; ASIR: age-standardized incidence rate; YLDs: years lived with disability; CYR: crude YLDs rate; ASYR: age-standardized YLDs rate.

Fig. 2

(A) Global incidence and (B) YLDs rate of foot fracture by age and sex in 1990 and 2019. YLDs: years lived with disability.

Fig. 3

The 9 leading causes for the incidence and YLDs rate of foot fracture in different age groups in 1990 and 2019. YLDs: years lived with disability.

Fig. 4

(A) ASIR and (B) ASYR of foot fracture for 21 GBD regions by SDI from 1990 to 2019. (C) ASIR and (D) ASYR of foot fracture for 204 countries and territories by SDI in 2019. The black line shows the trendline fit. The r and p values are calculated by Pearson's correlation analysis. ASIR: age-standardized incidence rate; YLDs: years lived with disability; ASYR: age-standardized YLDs rate; SDI: sociodemographic index.

Fig. 5

EAPC of ASIR of foot fracture from 1990 to 2019 by (A) ASIR and (B) SDI in 1990. EAPC of ASYR of foot fracture from 1990 to 2019 by (C) ASYR and (D) SDI in 1990. Points represent different countries and territories, with their size reflecting the number of cases in 1990. The black line shows the trendline fit. The r and p values are calculated by Pearson's correlation analysis. ASIR: age-standardized incidence rate; YLDs: years lived with disability; ASYR: age-standardized YLDs rate; SDI: sociodemographic index; EAPC: estimated annual percentage change.