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Global, Regional, and National Burden of Bone Fractures in 204 Countries and Territories, 1990–2019: A Systematic Analysis From the Global Burden of Disease Study 2019 Publisher Pubmed



Wu AM1 ; Bisignano C2 ; James SL6 ; Abady GG7 ; Abedi A8 ; Abugharbieh E9 ; Alhassan RK10 ; Alipour V11, 12 ; Arabloo J11 ; Asaad M15 ; Asmare WN16 ; Awedew AF17 ; Banach M18, 19 ; Banerjee SK20 Show All Authors
Authors
  1. Wu AM1
  2. Bisignano C2
  3. James SL6
  4. Abady GG7
  5. Abedi A8
  6. Abugharbieh E9
  7. Alhassan RK10
  8. Alipour V11, 12
  9. Arabloo J11
  10. Asaad M15
  11. Asmare WN16
  12. Awedew AF17
  13. Banach M18, 19
  14. Banerjee SK20
  15. Bijani A21
  16. Birhanu TTM22
  17. Bolla SR23
  18. Camera LA24, 25
  19. Chang JC27, 28
  20. Cho DY3
  21. Chung MY29
  22. Couto RAS30
  23. Dai X2
  24. Dandona L2, 32, 33
  25. Dandona R2, 4, 32
  26. Farzadfar F34
  27. Filip I36, 37
  28. Fischer F38
  29. Fomenkov AA39
  30. Gill TK40
  31. Gupta B41
  32. Haagsma JA42
  33. Hajmirzaian A35, 43
  34. Hamidi S44
  35. Hay SI2, 4
  36. Ilic IM45
  37. Ilic MD46
  38. Ivers RQ47
  39. Jurisson M48
  40. Kalhor R49, 50
  41. Kanchan T51
  42. Kavetskyy T52, 53
  43. Khalilov R54, 55
  44. Khan EA56
  45. Khan M57
  46. Kneib CJ3
  47. Krishnamoorthy V5, 58
  48. Kumar GA32
  49. Kumar N59
  50. Lalloo R60
  51. Lasrado S61
  52. Lim SS2, 4
  53. Liu Z2
  54. Manafi A13
  55. Manafi N14, 62
  56. Menezes RG63
  57. Meretoja TJ64, 65
  58. Miazgowski B66, 67
  59. Miller TR68, 69
  60. Mohammad Y70
  61. Mohammadianhafshejani A71
  62. Mokdad AH2, 4
  63. Murray CJL2, 4
  64. Naderi M72
  65. Naimzada MD74, 75
  66. Nayak VC76
  67. Nguyen CT78
  68. Nikbakhsh R43
  69. Olagunju AT79, 80
  70. Otstavnov N74
  71. Otstavnov SS74, 81
  72. Padubidri JR77
  73. Pereira J82
  74. Pham HQ78
  75. Pinheiro M31
  76. Polinder S42
  77. Pourchamani H73
  78. Rabiee N83
  79. Radfar A84
  80. Ur Rahman MH85
  81. Rawaf DL86, 88
  82. Rawaf S87, 89
  83. Saeb MR90
  84. Samy AM91
  85. Riera LS92, 93
  86. Schwebel DC94
  87. Shahabi S95
  88. Shaikh MA96
  89. Soheili A97
  90. Tabaresseisdedos R98, 99
  91. Tovanipalone MR100, 101
  92. Tran BX102
  93. Travillian RS2
  94. Valdez PR26, 103
  95. Vasankari TJ104
  96. Velazquez DZ105
  97. Venketasubramanian N106, 107
  98. Vu GT108
  99. Zhang ZJ109
  100. Vos T2, 4
Show Affiliations
Authors Affiliations
  1. 1. Department of Orthopaedics, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
  2. 2. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  3. 3. Division of Plastic Surgery, University of Washington, Seattle, WA, United States
  4. 4. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  5. 5. Department of Anesthesiology, University of Washington, Seattle, WA, United States
  6. 6. Personalized Healthcare, Genentech, San Francisco, CA, United States
  7. 7. Department of Nursing, Adigrat University, Adigrat, Ethiopia
  8. 8. Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, United States
  9. 9. Department of Clinical Sciences, University of Sharjah, Sharjah, United Arab Emirates
  10. 10. Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
  11. 11. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  12. 12. Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
  13. 13. Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran
  14. 14. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  15. 15. Department of Plastic Surgery, University of Texas, Houston, TX, United States
  16. 16. Department of Nursing, Mizan-Tepi University, Mizan Teferi, Ethiopia
  17. 17. Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
  18. 18. Department of Hypertension, Medical University of Lodz, Lodz, Poland
  19. 19. Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
  20. 20. School of Health Sciences, Walden University, Minneapolis, MN, United States
  21. 21. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  22. 22. Planning, Monitoring and Evaluation Directorate, Amhara Public Health Institute, Bahir Dar, Ethiopia
  23. 23. Department of Biomedical Sciences, Nazarbayev University, Nur-Sultan City, Kazakhstan
  24. 24. Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  25. 25. Board of Directors, Argentine Society of Medicine, Buenos Aires, Argentina
  26. 26. Argentine Society of Medicine, Buenos Aires, Argentina
  27. 27. College of Medicine, National Taiwan University, Taipei, Taiwan
  28. 28. Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
  29. 29. Department of Otolaryngology, Wayne State University, Detroit, MI, United States
  30. 30. Department of Chemical Sciences, University of Porto, Porto, Portugal
  31. 31. Department of Chemistry, University of Porto, Porto, Portugal
  32. 32. Public Health Foundation of India, Gurugram, India
  33. 33. Indian Council of Medical Research, New Delhi, India
  34. 34. Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  35. 35. Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
  36. 36. Psychiatry Department, Kaiser Permanente, Fontana, CA, United States
  37. 37. School of Health Sciences, A T Still University, Mesa, AZ, United States
  38. 38. Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
  39. 39. Department of Cell Biology and Biotechnology, K A Timiryazev Institute of Plant Physiology, Moscow, Russian Federation
  40. 40. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
  41. 41. Department of Public Health, Torrens University, Melbourne, VIC, Australia
  42. 42. Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
  43. 43. Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  44. 44. School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  45. 45. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  46. 46. Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
  47. 47. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
  48. 48. Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  49. 49. Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  50. 50. Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
  51. 51. Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
  52. 52. Department of Surface Engineering, The John Paul II Catholic University of Lublin, Lublin, Poland
  53. 53. Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
  54. 54. Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
  55. 55. Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russian Federation
  56. 56. Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan
  57. 57. Epidemiology Department, Jazan University, Jazan, Saudi Arabia
  58. 58. Department of Anesthesiology, Duke University, Durham, NC, United States
  59. 59. Department of Orthopaedics, Medanta Hospital, Lucknow, India
  60. 60. School of Dentistry, The University of Queensland, Brisbane, QLD, Australia
  61. 61. Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
  62. 62. School of Medicine, University of Manitoba, Winnipeg, MB, Canada
  63. 63. Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  64. 64. Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
  65. 65. University of Helsinki, Helsinki, Finland
  66. 66. Center for Innovation in Medical Education, Szczecin, Poland
  67. 67. Pomeranian Medical University, Szczecin, Poland
  68. 68. Pacific Institute for Research and Evaluation, Calverton, MD, United States
  69. 69. School of Public Health, Curtin University, Perth, WA, Australia
  70. 70. Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
  71. 71. Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
  72. 72. Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  73. 73. Clinical Research Development Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
  74. 74. Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation
  75. 75. Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russian Federation
  76. 76. Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
  77. 77. Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
  78. 78. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  79. 79. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
  80. 80. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  81. 81. Department of Project Management, National Research University Higher School of Economics, Moscow, Russian Federation
  82. 82. Department of Orthopedics, Yenepoya Medical College, Mangalore, India
  83. 83. Department of Chemistry, Sharif University of Technology, Tehran, Iran
  84. 84. College of Medicine, University of Central Florida, Orlando, FL, United States
  85. 85. Department of Community Medicine, Maharishi Markandeshwar Medical College and Hospital, Solan, India
  86. 86. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  87. 87. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  88. 88. University College London Hospitals, London, United Kingdom
  89. 89. Academic Public Health England, Public Health England, London, United Kingdom
  90. 90. CentraleSupelec, University of Lorraine, Metz, France
  91. 91. Department of Entomology, Ain Shams University, Cairo, Egypt
  92. 92. Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
  93. 93. Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, Australia
  94. 94. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
  95. 95. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  96. 96. Karachi, Pakistan
  97. 97. Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
  98. 98. Department of Medicine, University of Valencia, Valencia, Spain
  99. 99. Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
  100. 100. Department of Pathology and Legal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
  101. 101. Modestum, London, United Kingdom
  102. 102. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  103. 103. Velez Sarsfield Hospital, Buenos Aires, Argentina
  104. 104. UKK Institute, Tampere, Finland
  105. 105. Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacan Rosales, Mexico
  106. 106. Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
  107. 107. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  108. 108. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  109. 109. School of Medicine, Wuhan University, Wuhan, China

Source: The Lancet Healthy Longevity Published:2021


Abstract

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. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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