Objective: To investigate the epidemiological features and changing trends of disease burden of spinal cord injury (SCI) in China from 1990 to 2023, conduct decomposition analysis of disease burden changes, and provide evidence for SCI prevention and control.
Methods: Based on the 2023 Global Burden of Disease (GBD) study data, indicators including incidence and years lived with disability (YLDs) were used to analyze the status and changing trends of SCI disease burden in China from 1990 to 2023. The Gupta decomposition framework was applied to quantify the contributions of population growth, population aging, age-specific incidence rate changes, and disease severity changes to YLDs growth.
Results: In 2023, the number of SCI incidence cases in China was 232 700 cases, representing a 43.6% increase compared to 1990. From 1990 to 2023, the age-standardized YLDs rate of SCI decreased, while the age-standardized incidence rate showed an overall upward trend: it increased year by year from 1990 to 2015, declined briefly after 2015, and rose again from 2020. The disease burden of SCI in males was higher than in females. The age distribution of disease burden showed a shift toward older age groups, with incidence rates increasing with age among middle-aged and elderly populations. Falls were the main cause of SCI in China. Compared with 1990, YLDs in males and females increased by 48.58% and 41.72% respectively in 2023. The proportions of male growth attributed to population growth, population aging, age-specific incidence rate changes, and disease severity changes were 22.79%, 22.69%, 34.99%, and -31.88%, while those for females were 23.82%, 26.30%, 21.99%, and -30.40%.
Conclusion: From 1990 to 2023, population aging made a substantial contribution to the growth of SCI disease burden in China. The primary factor driving the growth of SCI disease burden differed by gender. Clinical interventions that mitigate disease severity represent a key strategy for addressing the rapid growth of SCI disease burden.
目的: 探讨1990—2023年中国脊髓损伤（spinal cord injury，SCI）的流行特征和疾病负担变化趋势，对疾病负担变化进行分解分析，为SCI防控提供依据。.
方法: 基于2023年全球疾病负担研究（Global Burden of Disease，GBD）数据库数据，利用发病和伤残损失寿命年（years lived with disability，YLDs）指标分析1990—2023年中国SCI疾病负担的现状和变化趋势，并采用Gupta分解框架量化人口增长、人口年龄结构演变、年龄别发病率变化及疾病严重程度变化对YLDs增长的贡献。.
结果: 2023年中国SCI发病人数为23.27万例，与1990年相比增加了43.6%。1990—2023年SCI标化YLDs率呈下降趋势；标化发病率在1990—2015年逐年上升，2015年后短暂回落，2020年起再度上升，整体呈上升趋势。男性SCI疾病负担高于女性。疾病负担的年龄分布呈现向更高年龄段推移的趋势，中老年人群发病率随年龄增长而升高。跌倒是中国SCI的主要伤害原因。相比于1990年，2023年男性和女性YLDs分别增长了48.58%和41.72%，男性增长归因于人口增长、人口老龄化、年龄别发病率变化和疾病严重程度变化的比例分别为22.79%、22.69%、34.99%和−31.88%，女性分别为23.82%、26.30%、21.99%和−30.40%。.
结论: 1990—2023年人口老龄化对中国SCI疾病负担增长有突出贡献，影响疾病负担增长的首要因素在不同性别存在差异。临床干预减轻疾病严重程度是应对SCI疾病负担快速增长的关键。.
Keywords: Gupta decomposition; Spinal cord injury; disease burden; incidence rate; years lived with disability.