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

Mahdi Safdarian; Eugen Trinka; GBD Spinal Cord Injuries Collaborators; Vafa Rahimi-Movaghar; Aljoscha Thomschewski; Amirali Aali; Gdiom Gebreheat Abady; Semagn Mekonnen Abate; Foad Abd-Allah; Aidin Abedi; Denberu Eshetie Adane; Saira Afzal; Bright Opoku Ahinkorah; Sajjad Ahmad; Haroon Ahmed; Nasir Amanat; Dhanalakshmi Angappan; Jalal Arabloo; Armin Aryannejad; Seyyed Shamsadin Athari; Alok Atreya; Sina Azadnajafabad; Ahmed Y. Azzam; Hassan Babamohamadi; Palash Chandra Banik; Mainak Bardhan; Azadeh Bashiri; Alemshet Yirga Berhie; Ajay Nagesh Bhat; Julie Brown; Ana Paula Champs; Periklis Charalampous; Isaac Sunday Chukwu; Kaleb Coberly; Omid Dadras; Dereje Y. Yada; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Fikadu Nugusu Dessalegn; Abebaw Alemayehu Desta; Sameer Dhingra; Nancy Diao; Daniel Diaz; Mahmoud Dibas; Deepa Dongarwar; Haneil Larson Dsouza; Michael Ekholuenetale; Juanita A. Haagsma; Van Thanh Nguyen; Suzanne Polinder

doi:10.1016/S1474-4422(23)00287-9

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

Mahdi Safdarian^*, Eugen Trinka, GBD Spinal Cord Injuries Collaborators, Vafa Rahimi-Movaghar, Aljoscha Thomschewski, Amirali Aali, Gdiom Gebreheat Abady, Semagn Mekonnen Abate, Foad Abd-Allah, Aidin Abedi, Denberu Eshetie Adane, Saira Afzal, Bright Opoku Ahinkorah, Sajjad Ahmad, Haroon Ahmed, Nasir Amanat, Dhanalakshmi Angappan, Jalal Arabloo, Armin Aryannejad, Seyyed Shamsadin AthariAlok Atreya, Sina Azadnajafabad, Ahmed Y. Azzam, Hassan Babamohamadi, Palash Chandra Banik, Mainak Bardhan, Azadeh Bashiri, Alemshet Yirga Berhie, Ajay Nagesh Bhat, Julie Brown, Ana Paula Champs, Periklis Charalampous, Isaac Sunday Chukwu, Kaleb Coberly, Omid Dadras, Dereje Y. Yada, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Fikadu Nugusu Dessalegn, Abebaw Alemayehu Desta, Sameer Dhingra, Nancy Diao, Daniel Diaz, Mahmoud Dibas, Deepa Dongarwar, Haneil Larson Dsouza, Michael Ekholuenetale, Juanita A. Haagsma, Van Thanh Nguyen, Suzanne Polinder

^*Corresponding author for this work

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Abstract

Background:

Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods:

Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury.

Findings:

Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (–6·1%, –17·2 to 1·5), and YLDs (–1·5%, –5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15–19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45–54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019.

Interpretation:

Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI.

Original language	English
Pages (from-to)	1026-1047
Number of pages	22
Journal	The Lancet Neurology
Volume	22
Issue number	11
DOIs	https://doi.org/10.1016/S1474-4422(23)00287-9
Publication status	Published - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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Cite this

Safdarian, M., Trinka, E., GBD Spinal Cord Injuries Collaborators, Rahimi-Movaghar, V., Thomschewski, A., Aali, A., Abady, G. G., Abate, S. M., Abd-Allah, F., Abedi, A., Adane, D. E., Afzal, S., Ahinkorah, B. O., Ahmad, S., Ahmed, H., Amanat, N., Angappan, D., Arabloo, J., Aryannejad, A., ... Polinder, S. (2023). Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 22(11), 1026-1047. https://doi.org/10.1016/S1474-4422(23)00287-9

@article{9235f5e7584a4423b0ca504176b86266,

title = "Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019",

abstract = "Background: Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. Findings: Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (–6·1%, –17·2 to 1·5), and YLDs (–1·5%, –5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15–19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45–54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. Interpretation: Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. ",

author = "Mahdi Safdarian and Eugen Trinka and {GBD Spinal Cord Injuries Collaborators} and Vafa Rahimi-Movaghar and Aljoscha Thomschewski and Amirali Aali and Abady, {Gdiom Gebreheat} and Abate, {Semagn Mekonnen} and Foad Abd-Allah and Aidin Abedi and Adane, {Denberu Eshetie} and Saira Afzal and Ahinkorah, {Bright Opoku} and Sajjad Ahmad and Haroon Ahmed and Nasir Amanat and Dhanalakshmi Angappan and Jalal Arabloo and Armin Aryannejad and Athari, {Seyyed Shamsadin} and Alok Atreya and Sina Azadnajafabad and Azzam, {Ahmed Y.} and Hassan Babamohamadi and Banik, {Palash Chandra} and Mainak Bardhan and Azadeh Bashiri and Berhie, {Alemshet Yirga} and Bhat, {Ajay Nagesh} and Julie Brown and Champs, {Ana Paula} and Periklis Charalampous and Chukwu, {Isaac Sunday} and Kaleb Coberly and Omid Dadras and Yada, {Dereje Y.} and Xiaochen Dai and Lalit Dandona and Rakhi Dandona and Dessalegn, {Fikadu Nugusu} and Desta, {Abebaw Alemayehu} and Sameer Dhingra and Nancy Diao and Daniel Diaz and Mahmoud Dibas and Deepa Dongarwar and Dsouza, {Haneil Larson} and Michael Ekholuenetale and Haagsma, {Juanita A.} and Nguyen, {Van Thanh} and Suzanne Polinder",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license",

year = "2023",

month = nov,

doi = "10.1016/S1474-4422(23)00287-9",

language = "English",

volume = "22",

pages = "1026--1047",

journal = "The Lancet Neurology",

issn = "1474-4422",

publisher = "Elsevier Ltd.",

number = "11",

}

Safdarian, M, Trinka, E, GBD Spinal Cord Injuries Collaborators, Rahimi-Movaghar, V, Thomschewski, A, Aali, A, Abady, GG, Abate, SM, Abd-Allah, F, Abedi, A, Adane, DE, Afzal, S, Ahinkorah, BO, Ahmad, S, Ahmed, H, Amanat, N, Angappan, D, Arabloo, J, Aryannejad, A, Athari, SS, Atreya, A, Azadnajafabad, S, Azzam, AY, Babamohamadi, H, Banik, PC, Bardhan, M, Bashiri, A, Berhie, AY, Bhat, AN, Brown, J, Champs, AP, Charalampous, P, Chukwu, IS, Coberly, K, Dadras, O, Yada, DY, Dai, X, Dandona, L, Dandona, R, Dessalegn, FN, Desta, AA, Dhingra, S, Diao, N, Diaz, D, Dibas, M, Dongarwar, D, Dsouza, HL, Ekholuenetale, M, Haagsma, JA, Nguyen, VT & Polinder, S 2023, 'Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019', The Lancet Neurology, vol. 22, no. 11, pp. 1026-1047. https://doi.org/10.1016/S1474-4422(23)00287-9

TY - JOUR

T1 - Global, regional, and national burden of spinal cord injury, 1990–2019

T2 - a systematic analysis for the Global Burden of Disease Study 2019

AU - Safdarian, Mahdi

AU - Trinka, Eugen

AU - GBD Spinal Cord Injuries Collaborators

AU - Rahimi-Movaghar, Vafa

AU - Thomschewski, Aljoscha

AU - Aali, Amirali

AU - Abady, Gdiom Gebreheat

AU - Abate, Semagn Mekonnen

AU - Abd-Allah, Foad

AU - Abedi, Aidin

AU - Adane, Denberu Eshetie

AU - Afzal, Saira

AU - Ahinkorah, Bright Opoku

AU - Ahmad, Sajjad

AU - Ahmed, Haroon

AU - Amanat, Nasir

AU - Angappan, Dhanalakshmi

AU - Arabloo, Jalal

AU - Aryannejad, Armin

AU - Athari, Seyyed Shamsadin

AU - Atreya, Alok

AU - Azadnajafabad, Sina

AU - Azzam, Ahmed Y.

AU - Babamohamadi, Hassan

AU - Banik, Palash Chandra

AU - Bardhan, Mainak

AU - Bashiri, Azadeh

AU - Berhie, Alemshet Yirga

AU - Bhat, Ajay Nagesh

AU - Brown, Julie

AU - Champs, Ana Paula

AU - Charalampous, Periklis

AU - Chukwu, Isaac Sunday

AU - Coberly, Kaleb

AU - Dadras, Omid

AU - Yada, Dereje Y.

AU - Dai, Xiaochen

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Dessalegn, Fikadu Nugusu

AU - Desta, Abebaw Alemayehu

AU - Dhingra, Sameer

AU - Diao, Nancy

AU - Diaz, Daniel

AU - Dibas, Mahmoud

AU - Dongarwar, Deepa

AU - Dsouza, Haneil Larson

AU - Ekholuenetale, Michael

AU - Haagsma, Juanita A.

AU - Nguyen, Van Thanh

AU - Polinder, Suzanne

PY - 2023/11

Y1 - 2023/11

N2 - Background: Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. Findings: Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (–6·1%, –17·2 to 1·5), and YLDs (–1·5%, –5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15–19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45–54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. Interpretation: Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI.

AB - Background: Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. Findings: Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (–6·1%, –17·2 to 1·5), and YLDs (–1·5%, –5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15–19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45–54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. Interpretation: Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI.

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U2 - 10.1016/S1474-4422(23)00287-9

DO - 10.1016/S1474-4422(23)00287-9

M3 - Article

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AN - SCOPUS:85174155895

SN - 1474-4422

VL - 22

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EP - 1047

JO - The Lancet Neurology

JF - The Lancet Neurology

IS - 11

ER -

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

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