Global, regional, and national burden and trends of traumatic brain injury in China and worldwide from 1990 to 2021: insights from the Global Burden of Disease Study 2021

Objectives This study aimed to describe the temporal trends in age- and gender-specific burdens of traumatic brain injury (TBI) in China from 1990 to 2021, including incidence, prevalence, and years lived with disability (YLDs), and to compare these trends with the global burden of the disease. Methods Using publicly available data from the Global Burden of Disease (GBD) database (1990–2021), this study analyzed the characteristics of TBI burden in China and globally, focusing on changes in incidence, prevalence, and YLDs. Joinpoint regression analysis was conducted to calculate the average annual percentage change (AAPC) and the corresponding 95% confidence interval (95% CI) to reflect trends in TBI burden. A comprehensive comparative analysis of TBI burden differences between China and the world was performed across multiple dimensions, including age, gender, and time periods. Results Between 1990 and 2021, the age-standardized incidence rate (ASIR) of TBI in China increased from 258.53/100,000 to 265.59/100,000, while the global ASIR decreased from 324.43/100,000 to 259.02/100,000. The age-standardized prevalence rate (ASPR) in China rose slightly from 473.63/100,000 to 481.66/100,000, whereas the global ASPR decreased from 536.72/100,000 to 448.04/100,000. The age-standardized YLDs rate (ASYR) in China increased marginally from 70.83/100,000 to 71.53/100,000, while the global ASYR declined from 77.27/100,000 to 64.76/100,000. The AAPCs of ASIR, ASPR, and ASYR in China were 0.08%, 0.05%, and 0.03%, respectively, in contrast to -0.80%, -0.58%, and -0.57% globally.Men demonstrated higher incidence and prevalence rates of TBI than women across most age groups, whereas women exhibited a greater burden in older age groups. Conclusion From 1990 to 2021, the ASIR, ASPR, and ASYR of TBI in China showed slight increases, indicating a growing burden of TBI. The burden of TBI is closely associated with age, with middle-aged adults exhibiting higher prevalence rates, while older populations face a greater burden of non-fatal disabilities. Men are more susceptible to TBI, bearing a higher burden in younger age groups, whereas women experience a notable increase in the burden among elderly populations. Given the substantial and rapidly aging population in China, this remains a significant challenge,underscoring the urgent need for targeted prevention and intervention strategies.