Global burden of vertebral fractures from 1990 to 2021 and projections for the next three decades

Abstract

Background: Vertebral fractures are linked to significant disability and mortality risks. Yet, existing studies on their global burden are outdated and lack predictive foresight.

Methods: Public data from the 2021 GBD study were analyzed to assess the global burden and epidemiological trends of vertebral fractures. The annual percentage change (EAPC) was calculated to represent temporal trends from 1990 to 2021. Machine learning was used to predict the global burden of vertebral fractures over the next 30 years.

Results: From 1990 to 2021, the global burden of vertebral fractures significantly decreased. The age-standardized incidence rates (ASIR) showed the largest decline in Eastern Sub-Saharan Africa (EAPC: -1.5; 95% CI: -2.0 to -1.0), while North Africa and the Middle East were the only regions to report an increase (EAPC: 0.3; 95% CI: 0.1 to 0.5). For age-standardized prevalence rates (ASPR), High-income Asia Pacific saw the steepest decline (EAPC: -1.4; 95% CI: -1.5 to -1.2), while the Caribbean experienced the largest increase (EAPC: 0.8; 95% CI: 0.4 to 1.3). Similarly, in terms of age-standardized years lived with disability rates (ASYR), the most substantial reduction occurred in High-income Asia Pacific (EAPC: -1.4; 95% CI: -1.5 to -1.3), with the Caribbean again showing the greatest rise (EAPC: 0.8; 95% CI: 0.3 to 1.2). Males generally exhibited higher age-standardized rates (ASRs) than females, although females aged 65-70 years old surpassed males. Predictive models suggest continued declines in global ASIR, ASPR, and ASYR by 2050.

Conclusions: Our study shows a steady reduction in the global burden of vertebral fractures from 1990 to 2021. Nevertheless, disparities remain across regions, with a positive correlation between ASRs with SDI.

Keywords: Epidemiological science; Global burden of disease study; Vertebral fractures.

Fig. 1.

The all-age cases, age-standardized incidence, prevalence, and YLDs from 1990 to 2021. a Incident cases and age standardized incidence rate; (b) Prevalent cases and age standardized prevalence rate; (c) YLD cases and age standardized YLD rate. YLD, years lived with disability.

Fig. 2.

The incidence, prevalence, and YLDs of vertebral fractures across different age groups in 2021. a Incidence; (b) Prevalence; (c) YLDs; (d) Age standardized incidence rate; (e) Age standardized prevalence rate; (f) Age standardized YLD rate. YLD, years lived with disability.

Fig. 3.

The causes associated with the incidence, prevalence and burden of vertebral fractures. a Age standardized incidence rate; (b) Age standardized prevalence rate; (c) Age standardized YLD rate. YLD, years lived with disability.

Fig. 4.

Global burden of vertebral fractures across 204 countries and territories in 2021. a Age-standardized incidence; (b) Age-standardized prevalence; (c) Age-standardized YLDs. YLD, years lived with disability.

Fig. 5.

SDI analysis results. a Incidence across 21 regions; (b) Prevalence across 21 regions; (c) YLDs across 21 regions. YLD, years lived with disability.

Fig. 6.

Decomposition analysis of the global disease burden. a Incidence across different SDI regions; (b) Prevalence across different SDI regions; (c) YLDs across different SDI regions. (d) Incidence by sex; (e) Prevalence by sex; (f) YLDs by sex. YLD, years lived with disability.

Fig. 7.

Predicted trends for vertebral fractures incidence, prevalence and YLDs. a Global age standardized prevalence rate; (b) Age standardized prevalence rate in meles; (c) Age standardized prevalence rate in femeles; (d) Global age standardized incidence rate; (e) Age standardized incidence rate in meles; (f) Age standardized incidence rate in femeles; (g) Global age standardized YLD rate; (h) Age standardized YLD rate in meles; (i) Age standardized YLD rate in femeles. YLD, years lived with disability.