Global epidemiological trends of moderate/severe TBI from 1990 to 2021: A study based on Global Burden of Disease...

Traumatic brain injury is a major cause of death and disability globally, especially moderate/severe traumatic brain injury (MSTBI), which has a significant impact on public health. The aim of this study is to systematically analyze the epidemiological characteristics of MSTBI worldwide from 1990 to 2021. The study measures the burden of MSTBI by gender at global, regional, and national levels based on the results of the Global Burden of Disease study 2021. Using clinically recorded data, it estimates the proportion of each type of injury that requires medical care and is ultimately identified as MSTBI. We applied Global Burden of Disease disability weights to calculate YLDs. It uses Bayesian meta-regression tools for epidemiological modeling, combined with the socio-demographic index (SDI), a composite indicator composed of per capita income, education, and fertility rate, to stratify countries and regions at different levels of development. In 2021, there were 11.8 million new cases of MSTBI worldwide (95% UI, 10.12-13.78 million), with an age-standardized incidence rate of 144.08 cases per 100,000 population (95% UI, 123.64-168.14). In the same year, MSTBI led to 4.42 million YLDs (95% UI, 3.11-5.98 million), corresponding to age-standardized rates of 52.17 per 100,000 population (95% UI, 36.64-70.52). From 1990 to 2021, the estimated annual percentage change of the incidence of MSTBI dropped by 0.5% (95% UI, -0.56 to -0.43), and the estimated annual percentage change of YLDs decreased by 0.49% (95% UI, -0.54 to -0.45). In 2021, high-middle SDI region had the highest age-standardized incidence (171.69 per 100,000 population, 95% UI, 147.16-199.97), while the high SDI region showed the lowest (93.28 per 100,000 population, 95% UI, 77.46-113.95). Similar regional disparities were evident for prevalence and YLDs. Males consistently exhibited higher incidence, prevalence, and YLD rates than females across most age groups and SDI quintiles. This study offers a scientific basis for the prevention and control strategies of MSTBI worldwide and emphasizes the urgency of strengthening preventive measures and enhancing medical conditions, especially in low- and middle-income countries.