Global, regional, and national burdens of traumatic brain injury in adolescents and young adults aged 10-24 years from 1990 to 2021: A secondary analysis of the Global Burden of Disease Study 2021

Background Traumatic brain injury (TBI) remains a critical global public health challenge, yet gaps in the evidence limit an understanding of its age-specific epidemiological profiles among adolescents and young adults. The aim of our analysis is to generate actionable evidence for tailoring prevention strategies and context-specific interventions aligned with the global epidemiological dataset in this population from 1990 to 2021. Methods We used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, which reported on TBI-related years lived with disability (YLDs), prevalence, and annual average percentage change (AAPC) per 100,000 people. Joinpoint regression analysis was used to identify years with significant trend shifts. We also performed stratified analyses by age, sex, and sociodemographicindex (SDI). Furthermore, we used the Bayesian age-period-cohort (BAPC) model to project the TBI burden through 2030. Results From 1990 to 2021, the prevalence of TBI among adolescents and young adults decreased from 191·3 per 100,000 people [177 to 208·9] to 128·3 per 100,000 people [117·8 to 139·1] (AAPC -1·28 [95% CI-1·31 to -1·26], p<0·001). Specific changes in the prevalence of TBI occurred in 2001, 2005, 2010, and 2017. Regionally, eastern sub-Saharan Africa had the most substantial reduction in prevalence rate (AAPC=-2·34[-2·62 to -2·05]) and YLD rates (AAPC=-2·32[-2·62 to -2·02]). The prevalence rate of TBI and YLDs attributable to TBI decreased in most countries except the Syrian Arab Republic, Yemen, Libya, Haiti, and the Central African Republic. Eritrea showed the most pronounced reduction in the TBI prevalence rate (AAPC=-7·6 95% UI: -7·76 to -7·45). The prevalence rate substantially decreasedin both sexes. The AAPC was -1·3 (95% CI -1·33 to -1·27) for males, which was comparable to the AAPC of -1·28 (95% CI -1·34 to -1·23) observed in females. Thelargest decrease in TBI prevalence from 1990 to 2021 was found among individuals aged 10-14 years (AAPC=-1·45[-1·49 to -1·41]). In terms of the SDI quintile, the most pronounced reductions in TBI prevalence and YLD rates occurred in the high-SDI quintile countries. Among all causes of TBI, falls constitute the leading etiology, with its proportional contribution rising steadily from 31·9% in 1990 to 37·7% in 2021. However,the BAPC analysis predicted that the prevalence of TBI and YLDs attributable to TBI would increasefrom 2022 to 2030. Conclusions The global burden of TBI in adolescents and young adults aged 10-24 years decreased from 1990 to 2021. This study is the first to report the global disease burden and temporal trends of TBI in adolescents and young adults. Although the disease burden has decreased in most regions, attention should still be givento specific regions to strengthen policy development and disease management.