Long-term trends in the burden of fracture of vertebral column in China: a comprehensive analysis from 1990 to 2021 based on the global burden of disease study 2021.

Background: Fracture of vertebral column (FVC) is a major public health problem, but the epidemiological investigation of FVC based on large population in China is still limited. This study aims to comprehensively analyze the disease burden of FVC in China from 1990 to 2021, so as to provide insights for public health policies and intervention measures.

Methods: Based on the Global Burden of Disease (GBD) database (1990-2021), the incidence, prevalence, and years lived with disability (YLDs) of FVC were evaluated. Joinpoint regression analysis was used to identify the significant change points of the trends. The age-period-cohort model was applied to analyze the age, period, and birth cohort effects. Decomposition analysis was conducted to quantify the contributions of population growth, aging, and epidemiological changes to the disease burden.

Results: In 2021, FVC had a significant impact on the health of the Chinese population, with a total of 1,194,465 cases reported. The incidence, prevalence, and YLDs for males was higher than those for females. From 1990 to 2021, the age standardized incidence rate (ASIR), age standardized prevalence rate (ASPR) and YLDs of FVC in China showed an upward trend, especially among the elderly population. In contrast, the global trend showed a decrease in ASIR, ASPR, and YLDs rate. Joinpoint regression analysis showed that the ASIR, ASPR, and YLDs of FVC in China increased significantly from 2011 to 2021. Decomposition analysis indicated that population growth and epidemiological changes were the main factors for the increasing burden of FVC. Etiological analysis showed that unintentional injuries and traffic accidents were the main causes of FVC in China.

Conclusion: FVC constitutes a significant health burden in China, especially among the elderly and male populations. These findings highlight the need to develop targeted public health policies and intervention measures, such as strengthening osteoporosis management and transportation safety, for decreasing disease burden of FVC.