@article{3106682,
    title = "Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016",
    author = "James, S.L. and Bannick, M.S. and Montjoy-Venning, W.C. and Lucchesi, L.R. and Dandona, L. and Dandona, R. and Hawley, C. and Hay, S.I. and Jakovljevic, M. and Khalil, I. and Krohn, K.J. and Mokdad, A.H. and Naghavi, M. and Nichols, E. and Reiner, R.C. and Smith, M. and Feigin, V.L. and Vos, T. and Murray, C.J.L. and Sunshine, J.E. and Yost, M.G. and Ellenbogen, R.G. and Kalani, R. and Morrison, S.D. and Crowe, C.S. and Massenburg, B.B. and Theadom, A. and Te Ao, B.J. and Balalla, S. and Jones, K.M. and Ofori-Asenso, R. and Li, S. and Sobhani, S. and Hosseini, S.M. and Mansournia, M.A. and Yaseri, M. and Anjomshoa, M. and Mousavi, S.M. and Haj-Mirzaian, A. and Haj-Mirzaian, A. and Malekzadeh, R. and Poustchi, H. and Roshandel, G. and Sepanlou, S.G. and Afarideh, M. and Esteghamati, A. and Esteghamati, S. and Ganji, M. and Kasaeian, A. and Rahimi-Movaghar, A. and Eskandarieh, S. and Sahraian, M.A. and Shams-Beyranvand, M. and Abbasi, N. and Farzadfar, F. and Irvani, S.N. and Rahimi-Movaghar, V. and Salamati, P. and Sharif-Alhoseini, M. and Fereshtehnejad, S.-M. and Mate, K.K.V. and Abdulkader, R. and Abraha, H.N. and Kassa, T.D. and Nirayo, Y.L. and Weldegwergs, K.G. and Gezae, K.E. and Zenebe, Z.M. and Degefa, M.G. and Kahsay, A. and Asgedom, S.W. and Gebre, A.K. and Yimer, E.M. and Belachew, A.B. and Meles, H. and Adsuar, J.C. and Zodpey, S. and Agrawal, S. and Awasthi, A. and Kumar, G.A. and Ahmadi, A. and Najafi, F. and Rajati, F. and Khazaie, H. and Farzaei, M.H. and Moradi, M. and Rezaei, S. and Soofi, M. and Siabani, S. and Rezaeian, S. and Ahmed, M.B. and Gebrehiwot, T.T. and Feyissa, G.T. and Hussen, M.A. and Aichour, A. and Aichour, I. and Aichour, M.T.E. and Akinyemi, R.O. and Owolabi, M.O. and Akseer, N. and Bhutta, Z.A. and Badawi, A. and Alahdab, F. and Kassa, G.M. and Alebel, A. and Wagnew, F.W.S. and Belay, Y.A. and Leshargie, C.T. and Alghnam, S.A. and Ali, B.A. and Alsharif, U. and Temsah, M.-H. and Altirkawi, K. and Davitoiu, D.V. and Hostiuc, S. and Beuran, M. and Negoi, I. and Andrei, C.L. and Ansari, H. and Ansha, M.G. and Antonio, C.A.T. and Appiah, S.C.Y. and Levi, M. and Ariani, F. and Biffino, M. and Asefa, N.G. and Atique, S. and Rahman, M.A. and Wijeratne, T. and Ayala Quintanilla, B.P. and Ayuk, T.B. and Azzopardi, P.S. and Rafiei, A. and Badali, H. and Mohammadi, M. and Moosazadeh, M. and Daryani, A. and Banstola, A. and Tran, K.B. and Barker-Collo, S.L. and Bärnighausen, T.W. and Bedi, N. and Tehrani-Banihashemi, A. and Shabaninejad, H. and Behzadifar, Ma. and Kabir, A. and Yousefifard, M. and Moradi-Lakeh, M. and Behzadifar, Me. and Bekele, B. and Hassen, H.Y. and Henok, A. and Biadgo, B. and Bennett, D.A. and Goulart, A.C. and Bensenor, I.M. and Lotufo, P.A. and Wang, Y.P. and Yisma, E. and Berhane, A. and Deribe, K. and Yasin, Y.J. and Demoz, G.T. and Bhalla, A. and Bhaumik, S. and Bijani, A. and Zamani, M. and Bililign, N. and Kumar, M. and Birungi, C. and Boufous, S. and Brazinova, A. and Brown, A.W. and Car, M. and Majeed, A. and Rawaf, S. and Rawaf, D.L. and Shoman, H. and Cárdenas, R. and Carrero, J.J. and El-Khatib, Z. and Roy, N. and Carvalho, F. and Santos, J.V. and Fernandes, E. and Silva, J.P. and Castañeda-Orjuela, C.A. and Hoffman, H.J. and Catalá-López, F. and Chaiah, Y. and Temsah, O. and Champs, A.P. and Chang, J.-C. and Choi, J.-Y.J. and Christopher, D.J. and Cooper, C. and Djalalinia, S. and Do, H.P. and Nguyen, T.H. and Doku, D.T. and Drake, T.M. and Sheikh, A. and Soyiri, I.N. and Dubey, M. and Santric Milicevic, M.M.M. and Dubljanin, E. and Faro, A. and Filip, I. and Radfar, A. and Fischer, F. and Fukumoto, T. and Gankpe, F.G. and Gopalkrishna, G. and Haagsma, J.A. and Polinder, S. and Khoja, A.T. and Pinilla-Monsalve, G.D. and Hamadeh, R.R. and Hamidi, S. and Haro, J.M. and Hassankhani, H. and Havmoeller, R. and Hegazy, M.I. and Hendrie, D. and Miller, T.R. and Hibstu, D.T. and Kassa, Z.Y. and Hole, M.K. and Homaie Rad, E. and Hu, G. and Ilesanmi, O.S. and Jayaraman, S. and Jha, R.P. and Jonas, J.B. and Moazen, B. and Jorjoran Shushtari, Z. and Jozwiak, J.J. and Jürisson, M. and Kahssay, M. and Liben, M.L. and Karch, A. and Kengne, A.P. and Khader, Y.S. and Safari, H. and Khafaie, M.A. and Khalid, N. and Khan, E.A. and Khan, M.S. and Usman, M.S. and Siddiqi, T.J. and Khang, Y.-H. and Khubchandani, J. and Kiadaliri, A.A. and Kim, D. and Kim, Y.-E. and Yoon, S.-J. and Kisa, A. and Winkler, A.S. and Koyanagi, A. and Kuate Defo, B. and Kucuk Bicer, B. and Lalloo, R. and Moradinazar, M. and Lami, F.H. and Lansingh, V.C. and Laryea, D.O. and Latifi, A. and Safiri, S. and Lunevicius, R. and Mahotra, N.B. and Majdan, M. and Manda, A.-L. and Mehndiratta, M.M. and Mehta, V. and Melese, A. and Memiah, P.T.N. and Mendoza, W. and Mengistu, G. and Shiferaw, M.S. and Tekle, M.G. and Meretoja, T.J. and Meretoja, A. and Szoeke, C.E.I. and Mestrovich, T. and Miazgowski, T. and Mini, G.K. and Mirica, A. and Mirrakhimov, E.M. and Molokhia, M. and Monast, L. and Ronfani, L. and Mondello, S. and Moradi, G. and Moschos, M.M. and Murthy, S. and Musa, K.I. and Mustafa, G. and Naik, G. and Schwebel, D.C. and Nangia, V. and Nascimento, B.R. and Ningrum, D.N.A. and Nyasulu, P.S. and Renzaho, A.M.N. and Ogbo, F.A. and Oh, I.-H. and Okoro, A. and Olagunju, A.T. and Olagunju, T.O. and Olivares, P.R. and Otstavnov, S.S. and Dnb, M.P.A. and Pakhale, S. and Pandey, A.R. and Pesudovs, K. and Prakash, S. and Qorbani, M. and Rafay, A. and Rahman, M. and Stokes, M.A. and Shariful Islam, S.M. and Rai, R.K. and Ram, U. and Reis, C. and Resnikoff, S. and Roever, L. and Sunguy, B.F. and Ruhago, G.M. and Saddik, B. and Saldanha, R.D.F. and Samy, A.M. and Sanabria, J. and Sartorius, B. and Satpathy, M. and Schneider, I.J.C. and Shaikh, M.A.A. and Sharif, M. and She, J. and Shen, J. and Sheth, K.N. and Shibuya, K. and Shigematsu, M. and Shiri, R. and Shiue, I. and Silveira, D.A. and Soares Filho, A.M. and Sinha, D.N. and Soriano, J.B. and Stein, D.J. and Sufiyan, M.B. and Sykes, B.L. and Tabarés-Seisdedos, R. and Tortajada-Girbés, M. and Topor-Madry, R. and Tran, B.X. and Tudor Car, L. and Ukwaja, K.N. and Ullah, I. and Uthman, O.A. and Valdez, P.R. and Vasankari, T.J. and Venketasubramanian, N. and Violante, F.S. and Waheed, Y. and Werdecker, A. and Wyper, G.M.A. and Yano, Y. and Ye, P. and Yip, P. and Yonemoto, N. and Younis, M.Z. and Yu, C. and Zaidi, Z. and Zaman, S.B. and GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators",
    journal = "The Lancet Neurology",
    year = "2019",
    volume = "18",
    number = "1",
    pages = "56-87",
    publisher = "The Lancet Publishing Group",
    doi = "10.1016/S1474-4422(18)30415-0",
    keywords = "Article;  disability;  fertility;  global disease burden;  human;  incidence;  income;  medical care;  multiple trauma;  prevalence;  priority journal;  spinal cord injury;  standardized mortality ratio;  systematic review;  traumatic brain injury;  adolescent;  adult;  aged;  child;  female;  infant;  male;  middle aged;  newborn;  preschool child;  quality adjusted life year;  spinal cord injury;  traumatic brain injury;  very elderly;  young adult, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Brain Injuries, Traumatic;  Child;  Child, Preschool;  Female;  Global Burden of Disease;  Humans;  Incidence;  Infant;  Infant, Newborn;  Male;  Middle Aged;  Prevalence;  Quality-Adjusted Life Years;  Spinal Cord Injuries;  Young Adult",
    abstract = "Background Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used causespecific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, there were 27.08 million (95% uncertainty interval [UI] 24.30-30.30 million) new cases of TBI and 0.93 million (0.78-1.16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55.50 million (53.40-57.62 million) and of SCI was 27.04 million (24.98-30.15 million). From 1990 to 2016, the agestandardised prevalence of TBI increased by 8.4% (95% UI 7.7 to 9.2), whereas that of SCI did not change significantly (-0.2% [-2.1 to 2.7]). Age-standardised incidence rates increased by 3.6% (1.8 to 5.5) for TBI, but did not change significantly for SCI (-3.6% [-7.4 to 4.0]). TBI caused 8.1 million (95% UI 6.0-10.4 million) YLDs and SCI caused 9.5 million (6.7-12.4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. © 2018 The Author(s)."
}