Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019

doi:10.1186/s13049-024-01258-2

. 2024 Sep 16;32(1):89.

doi: 10.1186/s13049-024-01258-2.

Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019

Qingsong Chen^{1

2}, Guangbin Huang², Tao Li², Qi Zhang², Ping He², Jun Yang², Yongming Li^{3

4}, Dingyuan Du^{5

6}

Affiliations

¹ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China.
² Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China.
³ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China. yongmingli@cqu.edu.cn.
⁴ Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China. yongmingli@cqu.edu.cn.
⁵ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China. dudingyuan@qq.com.
⁶ Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China. dudingyuan@qq.com.

PMID: 39285499
PMCID: PMC11403847
DOI: 10.1186/s13049-024-01258-2

Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019

Qingsong Chen et al. Scand J Trauma Resusc Emerg Med. 2024.

. 2024 Sep 16;32(1):89.

doi: 10.1186/s13049-024-01258-2.

Authors

Qingsong Chen^{1

2}, Guangbin Huang², Tao Li², Qi Zhang², Ping He², Jun Yang², Yongming Li^{3

4}, Dingyuan Du^{5

6}

Affiliations

¹ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China.
² Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China.
³ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China. yongmingli@cqu.edu.cn.
⁴ Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China. yongmingli@cqu.edu.cn.
⁵ School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China. dudingyuan@qq.com.
⁶ Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China. dudingyuan@qq.com.

PMID: 39285499
PMCID: PMC11403847
DOI: 10.1186/s13049-024-01258-2

Abstract

Background: This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China.

Methods: In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050.

Results: In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of - 6.85% (95% confidence interval [CI] - 11.11, - 2.37), while Liberia's ASPR and ASYR declined with EAPCs of - 3.22% (95% CI - 4.73, - 1.69) and - 5.67% (95% CI - 8.00, - 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR.

Conclusions: This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden.

Keywords: ARIMA model; Age-period-cohort; Causes; Global Burden of Disease 2019; Incidence; Prevalence; Severe chest injury; Years lived with disability.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
GBD regional distribution of ASIR, ASPR, and ASYR of severe chest injury in 2019. A ASIR. B ASPR. C ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate. *ASYR* Age-standardized YLDs rate

**Fig. 2**
Geographical distribution of ASIR, ASPR, and ASYR of severe chest injury in 2019. A ASIR. B ASPR. C ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate

**Fig. 3**
Geographical distribution of ASIR, ASPR, and ASYR of severe chest injury from 1990 to 2019. A EPACs in the ASIR. B EPACs in the ASPR. C EPACs in the ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *EAPCs* Estimated annual percentage changes. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate. *ASYR* Age-standardized YLDs rate

**Fig. 4**
ASIR, ASPR, and ASYR of severe chest injury among SDI quintiles from 1990 to 2019. A EPACs in the ASIR. B EPACs in the ASPR. C EPACs in the ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *SDI* Social Demographic Index, *EAPCs* Estimated annual percentage changes. YLD = years lived with disability. ASIR = age-standardized incidence rate, *ASPR* Age-standardized prevalence rate. *ASYR* Age-standardized YLDs rate

**Fig. 5**
Age distribution of ASIR, ASPR, and ASYR of severe chest injury from 1990 to 2019 globally and in China. A ASIR. B ASPR. C ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate

**Fig. 6**
Gender distribution of ASIR, ASPR, and ASYR of severe chest injury from 1990 to 2019 globally and in China. A ASIR. B ASPR. C ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate

**Fig. 7**
Influential factors affecting EAPC in the GBD. A correlation of EAPC with ASIR, ASPR, and ASYR in 1990. B correlation of EAPC with ASIR, ASPR, and ASYR in 2019. C correlation of EAPC with HDI in 2019. r and P values were obtained using Pearson correlation. *EAPCs* Estimated annual percentage changes, *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate

**Fig. 8**
Level 4 causes of severe chest injury in various SDI regions and globally versus China. A ASIR. B ASPR. C ASYR. D the number of incidence cases. E the number of prevalent cases. F the number of YLD cases. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate, *SDI* Social Demographic Index

**Fig. 9**
Level 4 causes of severe chest injury globally and in China, stratified by age group and gender, between 1990 and 2019. A global stacked pyramid charts of the ASIR, ASPR, and ASYR along with the number of incidence, prevalence, and YLD. B China stacked pyramid charts of the ASIR, ASPR, and ASYR along with the number of incidence, prevalence, and YLD. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate, *SDI* Social Demographic Index

**Fig. 10**
Age, period, and cohort effect relative risk of severe chest injury incidence, prevalence, and YLD globally and in China, 1990–2019. A ASIR. B ASPR. C ASYR. D ASIR. E ASPR. F ASYR. *YLD* Years lived with disability, *ASIR* Age-standardized incidence rate, *ASPR* Age-standardized prevalence rate, *ASYR* Age-standardized YLDs rate

**Fig. 11**
Predicted trends of severe chest injury in 2020–2050 by the ARIMA model. A Global ARIMA model. B China ARIMA model. *ARIMA* Autoregressive integrated moving average

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References

1. Garcia A, Martinez J, Rodriguez J, Millan M, Valderrama G, Ordoñez C, et al. Damage-control techniques in the management of severe lung trauma. J Trauma Acute Care Surg. 2015;78(1):45–50. 10.1097/TA.0000000000000482 - DOI - PMC - PubMed
1. Dhar SM, Breite MD, Barnes SL, Quick JA. Pulmonary contusion in mechanically ventilated subjects after severe trauma. Respir Care. 2018;63(8):950–4. 10.4187/respcare.05952 - DOI - PubMed
1. Platz JJ, Fabricant L, Norotsky M. Thoracic trauma: injuries, evaluation, and treatment. Surg Clin North Am. 2017;97(4):783–99. 10.1016/j.suc.2017.03.004 - DOI - PubMed
1. Bayer J, Lefering R, Reinhardt S, Kühle J, Südkamp NP, Hammer T. Severity-dependent differences in early management of thoracic trauma in severely injured patients—analysis based on the TraumaRegister DGU®. Scand J Trauma Resusc Emerg Med. 2017;25(1):10. 10.1186/s13049-017-0354-4 - DOI - PMC - PubMed
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[1] Garcia A, Martinez J, Rodriguez J, Millan M, Valderrama G, Ordoñez C, et al. Damage-control techniques in the management of severe lung trauma. J Trauma Acute Care Surg. 2015;78(1):45–50. 10.1097/TA.0000000000000482 - DOI - PMC - PubMed

[2] Garcia A, Martinez J, Rodriguez J, Millan M, Valderrama G, Ordoñez C, et al. Damage-control techniques in the management of severe lung trauma. J Trauma Acute Care Surg. 2015;78(1):45–50. 10.1097/TA.0000000000000482 - DOI - PMC - PubMed

[3] Dhar SM, Breite MD, Barnes SL, Quick JA. Pulmonary contusion in mechanically ventilated subjects after severe trauma. Respir Care. 2018;63(8):950–4. 10.4187/respcare.05952 - DOI - PubMed

[4] Dhar SM, Breite MD, Barnes SL, Quick JA. Pulmonary contusion in mechanically ventilated subjects after severe trauma. Respir Care. 2018;63(8):950–4. 10.4187/respcare.05952 - DOI - PubMed

[5] Platz JJ, Fabricant L, Norotsky M. Thoracic trauma: injuries, evaluation, and treatment. Surg Clin North Am. 2017;97(4):783–99. 10.1016/j.suc.2017.03.004 - DOI - PubMed

[6] Platz JJ, Fabricant L, Norotsky M. Thoracic trauma: injuries, evaluation, and treatment. Surg Clin North Am. 2017;97(4):783–99. 10.1016/j.suc.2017.03.004 - DOI - PubMed

[7] Bayer J, Lefering R, Reinhardt S, Kühle J, Südkamp NP, Hammer T. Severity-dependent differences in early management of thoracic trauma in severely injured patients—analysis based on the TraumaRegister DGU®. Scand J Trauma Resusc Emerg Med. 2017;25(1):10. 10.1186/s13049-017-0354-4 - DOI - PMC - PubMed

[8] Bayer J, Lefering R, Reinhardt S, Kühle J, Südkamp NP, Hammer T. Severity-dependent differences in early management of thoracic trauma in severely injured patients—analysis based on the TraumaRegister DGU®. Scand J Trauma Resusc Emerg Med. 2017;25(1):10. 10.1186/s13049-017-0354-4 - DOI - PMC - PubMed

[9] Fenton SJ, Hunt MM, Ropski PS, Scaife ER, Russell KW. Use of ECMO support in pediatric patients with severe thoracic trauma. J Pediatr Surg. 2019;54(11):2358–62. 10.1016/j.jpedsurg.2019.02.018 - DOI - PubMed

[10] Fenton SJ, Hunt MM, Ropski PS, Scaife ER, Russell KW. Use of ECMO support in pediatric patients with severe thoracic trauma. J Pediatr Surg. 2019;54(11):2358–62. 10.1016/j.jpedsurg.2019.02.018 - DOI - PubMed

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Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019

Affiliations

Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019

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Conflict of interest statement

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