Trends, Drivers and Projections of Pressure Injury Burden in China: Implications for National Healthcare Policy and...

Pressure injuries represent a significant public health challenge in the context of global population aging. As China faces rapid aging, the characteristics of its disease burden and the strategies for prevention and control remain unclear. This study analyses the trends in the disease burden of pressure injuries in China over the past 30 years, based on the Global Burden of Disease (GBD) 2021 data, and predicts the future trends over the next 20 years. The GBD 2021 data were used in combination with the Joinpoint regression model, age-period-cohort (APC) model and Bayesian age-period-cohort (BAPC) model to analyse the burden of pressure injuries in China from 1990 to 2021 and forecast trends from 2022 to 2040. Additionally, decomposition analysis was performed to quantify the contribution of population aging to the disease burden. In 2021, the number of people with pressure injuries in China was 102 938.9, the number of new cases was 397 312.3, the disability-adjustede life years (DALYs) totaled 27 383.5 and the number of deaths was 3131.5. The gender difference was characterised by 'higher prevalence in middle-aged men, with a reversal in very old women'. Between 1990 and 2021, the burden of pressure injuries significantly increased, with population aging being the main driving factor (46.5%-65.0%). The cohort effect indicated a higher risk for those born before 1942 (RR = 1.04-1.86), and a decreasing risk for those born after 1960 (RR = 0.91). Future projections suggest a 25.8% decrease in total cases, but an increased burden in those aged 85 and older, with deaths rising by 127%. This study highlights the aging-driven burden of pressure injuries in China, along with gender differences and typical period and cohort effects. As the population ages, the burden of pressure injuries in older age groups will continue to rise. The findings provide evidence for the 'Healthy China 2030' initiative and call for the inclusion of pressure injury prevention and control in the core agenda of national aging governance.