TY - JOUR
T1 - Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019
T2 - a systematic analysis from the Global Burden of Disease Study 2019
AU - GBD 2019 Fracture Collaborators
AU - Wu, Ai Min
AU - Bisignano, Catherine
AU - James, Spencer L.
AU - Abady, Gdiom Gebreheat
AU - Abedi, Aidin
AU - Abu-Gharbieh, Eman
AU - Alhassan, Robert Kaba
AU - Alipour, Vahid
AU - Arabloo, Jalal
AU - Asaad, Malke
AU - Asmare, Wondwossen Niguse
AU - Awedew, Atalel Fentahun
AU - Banach, Maciej
AU - Banerjee, Srikanta K.
AU - Bijani, Ali
AU - Birhanu, Tesega Tesega Mengistu
AU - Bolla, Srinivasa Rao
AU - Cámera, Luis Alberto
AU - Chang, Jung Chen
AU - Cho, Daniel Youngwhan
AU - Chung, Michael T.
AU - Couto, Rosa A.S.
AU - Dai, Xiaochen
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Farzadfar, Farshad
AU - Filip, Irina
AU - Fischer, Florian
AU - Fomenkov, Artem Alekseevich
AU - Gill, Tiffany K.
AU - Gupta, Bhawna
AU - Haagsma, Juanita A.
AU - Haj-Mirzaian, Arvin
AU - Hamidi, Samer
AU - Hay, Simon I.
AU - Ilic, Irena M.
AU - Ilic, Milena D.
AU - Ivers, Rebecca Q.
AU - Jürisson, Mikk
AU - Kalhor, Rohollah
AU - Kanchan, Tanuj
AU - Kavetskyy, Taras
AU - Khalilov, Rovshan
AU - Khan, Ejaz Ahmad
AU - Khan, Maseer
AU - Kneib, Cameron J.
AU - Krishnamoorthy, Vijay
AU - Kumar, G. Anil
AU - Kumar, Narinder
AU - Nayak, Vinod C.
AU - Rao P P, Jagadish
N1 - Funding Information:
I Filip reports financial support from Avicenna Medical and Clinical Research Institute. R Q Ivers reports grants from National and Medical Research Council of Australia during the conduct of the study. S L James reports employment with Genentech/Roche beginning in 2020, and project funding from Sanofi Pasteur from 2019–2020, outside the submitted work. All other authors declare no competing interests.
Funding Information:
S K Banerjee acknowledges the Walden University Social Change Grant. A A Fomenkov was partially supported through Megagrant project number 075-15-2019-1882. A M Samy acknowledges support from the Egyptian Fulbright Mission Program.
Publisher Copyright:
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2021/9
Y1 - 2021/9
N2 - Background: Bone fractures are a global public health issue; however, to date, no comprehensive study of their incidence and burden has been done. We aimed to measure the global, regional, and national incidence, prevalence, and years lived with disability (YLDs) of fractures from 1990 to 2019. Methods: Using the framework of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we compared numbers and age-standardised rates of global incidence, prevalence, and YLDs of fractures across the 21 GBD regions and 204 countries and territories, by age, sex, and year, from 1990 to 2019. We report estimates with 95% uncertainty intervals (UIs). Findings: Globally, in 2019, there were 178 million (95% UI 162–196) new fractures (an increase of 33·4% [30·1–37·0] since 1990), 455 million (428–484) prevalent cases of acute or long-term symptoms of a fracture (an increase of 70·1% [67·5–72·5] since 1990), and 25·8 million (17·8–35·8) YLDs (an increase of 65·3% [62·4–68·0] since 1990). The age-standardised rates of fractures in 2019 were 2296·2 incident cases (2091·1–2529·5) per 100 000 population (a decrease of 9·6% [8·1–11·1] since 1990), 5614·3 prevalent cases (5286·1–5977·5) per 100 000 population (a decrease of 6·7% [5·7–7·6] since 1990), and 319·0 YLDs (220·1–442·5) per 100 000 population (a decrease of 8·4% [7·2–9·5] since 1990). Lower leg fractures of the patella, tibia or fibula, or ankle were the most common and burdensome fracture in 2019, with an age-standardised incidence rate of 419·9 cases (345·8–512·0) per 100 000 population and an age-standardised rate of YLDs of 190·4 (125·0–276·9) per 100 000 population. In 2019, age-specific rates of fracture incidence were highest in the oldest age groups, with, for instance, 15 381·5 incident cases (11 245·3–20 651·9) per 100 000 population in those aged 95 years and older. Interpretation: The global age-standardised rates of incidence, prevalence, and YLDs for fractures decreased slightly from 1990 to 2019, but the absolute counts increased substantially. Older people have a particularly high risk of fractures, and more widespread injury-prevention efforts and access to screening and treatment of osteoporosis for older individuals should help to reduce the overall burden. Funding: Bill & Melinda Gates Foundation.
AB - Background: Bone fractures are a global public health issue; however, to date, no comprehensive study of their incidence and burden has been done. We aimed to measure the global, regional, and national incidence, prevalence, and years lived with disability (YLDs) of fractures from 1990 to 2019. Methods: Using the framework of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we compared numbers and age-standardised rates of global incidence, prevalence, and YLDs of fractures across the 21 GBD regions and 204 countries and territories, by age, sex, and year, from 1990 to 2019. We report estimates with 95% uncertainty intervals (UIs). Findings: Globally, in 2019, there were 178 million (95% UI 162–196) new fractures (an increase of 33·4% [30·1–37·0] since 1990), 455 million (428–484) prevalent cases of acute or long-term symptoms of a fracture (an increase of 70·1% [67·5–72·5] since 1990), and 25·8 million (17·8–35·8) YLDs (an increase of 65·3% [62·4–68·0] since 1990). The age-standardised rates of fractures in 2019 were 2296·2 incident cases (2091·1–2529·5) per 100 000 population (a decrease of 9·6% [8·1–11·1] since 1990), 5614·3 prevalent cases (5286·1–5977·5) per 100 000 population (a decrease of 6·7% [5·7–7·6] since 1990), and 319·0 YLDs (220·1–442·5) per 100 000 population (a decrease of 8·4% [7·2–9·5] since 1990). Lower leg fractures of the patella, tibia or fibula, or ankle were the most common and burdensome fracture in 2019, with an age-standardised incidence rate of 419·9 cases (345·8–512·0) per 100 000 population and an age-standardised rate of YLDs of 190·4 (125·0–276·9) per 100 000 population. In 2019, age-specific rates of fracture incidence were highest in the oldest age groups, with, for instance, 15 381·5 incident cases (11 245·3–20 651·9) per 100 000 population in those aged 95 years and older. Interpretation: The global age-standardised rates of incidence, prevalence, and YLDs for fractures decreased slightly from 1990 to 2019, but the absolute counts increased substantially. Older people have a particularly high risk of fractures, and more widespread injury-prevention efforts and access to screening and treatment of osteoporosis for older individuals should help to reduce the overall burden. Funding: Bill & Melinda Gates Foundation.
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U2 - 10.1016/S2666-7568(21)00172-0
DO - 10.1016/S2666-7568(21)00172-0
M3 - Article
AN - SCOPUS:85119900300
SN - 2666-7568
VL - 2
SP - e580-e592
JO - The Lancet Healthy Longevity
JF - The Lancet Healthy Longevity
IS - 9
ER -
