Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017

Spencer L James 1, Chris D Castle 2, Zachary V Dingels 2, Jack T Fox 2, Erin B Hamilton 2, Zichen Liu 2, Nicholas L S Roberts 2, Dillon O Sylte 2, Nathaniel J Henry 2, Kate E LeGrand 2, Ahmed Abdelalim 3, Amir Abdoli 4, Ibrahim Abdollahpour 5, Rizwan Suliankatchi Abdulkader 6, Aidin Abedi 7, Akine Eshete Abosetugn 8, Abdelrahman I Abushouk 9, Oladimeji M Adebayo 10, Marcela Agudelo-Botero 11, Tauseef Ahmad 12 13, Rushdia Ahmed 14 15, Muktar Beshir Ahmed 16, Miloud Taki Eddine Aichour 17, Fares Alahdab 18, Genet Melak Alamene 19, Fahad Mashhour Alanezi 20, Animut Alebel 21, Niguse Meles Alema 22, Suliman A Alghnam 23, Samar Al-Hajj 24 25, Beriwan Abdulqadir Ali 26 27, Saqib Ali 28, Mahtab Alikhani 29, Cyrus Alinia 30, Vahid Alipour 31 32, Syed Mohamed Aljunid 33 34, Amir Almasi-Hashiani 35, Nihad A Almasri 36, Khalid Altirkawi 37, Yasser Sami Abdeldayem Amer 38 39, Saeed Amini 40, Arianna Maever Loreche Amit 41 42, Catalina Liliana Andrei 43, Alireza Ansari-Moghaddam 44, Carl Abelardo T Antonio 45 46, Seth Christopher Yaw Appiah 47 48, Jalal Arabloo 31, Morteza Arab-Zozani 49, Zohreh Arefi 50, Olatunde Aremu 51, Filippo Ariani 52, Amit Arora 53 54, Malke Asaad 55, Babak Asghari 56, Nefsu Awoke 57, Beatriz Paulina Ayala Quintanilla 58 59, Getinet Ayano 60, Martin Amogre Ayanore 61, Samad Azari 31, Ghasem Azarian 62, Alaa Badawi 63 64, Ashish D Badiye 65, Eleni Bagli 66 67, Atif Amin Baig 68 69, Mohan Bairwa 70 71, Ahad Bakhtiari 72, Arun Balachandran 73 74, Maciej Banach 75 76, Srikanta K Banerjee 77, Palash Chandra Banik 78, Amrit Banstola 79, Suzanne Lyn Barker-Collo 80, Till Winfried Bärnighausen 81 82, Lope H Barrero 83, Akbar Barzegar 84, Mohsen Bayati 85, Bayisa Abdissa Baye 86, Neeraj Bedi 87 88, Masoud Behzadifar 89, Tariku Tesfaye Bekuma 90, Habte Belete 91, Corina Benjet 92, Derrick A Bennett 93, Isabela M Bensenor 94, Kidanemaryam Berhe 95, Pankaj Bhardwaj 96 97, Anusha Ganapati Bhat 98, Krittika Bhattacharyya 99 100, Sadia Bibi 101, Ali Bijani 102, Muhammad Shahdaat Bin Sayeed 103 104, Guilherme Borges 92, Antonio Maria Borzì 105, Soufiane Boufous 106, Alexandra Brazinova 107, Nikolay Ivanovich Briko 108, Shyam S Budhathoki 109, Josip Car 110 111, Rosario Cárdenas 112, Félix Carvalho 113, João Mauricio Castaldelli-Maia 114, Carlos A Castañeda-Orjuela 115 116, Giulio Castelpietra 117 118, Ferrán Catalá-López 119 120, Ester Cerin 121 122, Joht S Chandan 123, Wagaye Fentahun Chanie 124, Soosanna Kumary Chattu 125, Vijay Kumar Chattu 126, Irini Chatziralli 127 128, Neha Chaudhary 129 130, Daniel Youngwhan Cho 131, Mohiuddin Ahsanul Kabir Chowdhury 132 133, Dinh-Toi Chu 134, Samantha M Colquhoun 135, Maria-Magdalena Constantin 136 137, Vera M Costa 113, Giovanni Damiani 138 139, Ahmad Daryani 140, Claudio Alberto Dávila-Cervantes 141, Feleke Mekonnen Demeke 142, Asmamaw Bizuneh Demis 143 144, Gebre Teklemariam Demoz 145 146, Desalegn Getnet Demsie 22, Afshin Derakhshani 147, Kebede Deribe 148 149, Rupak Desai 150, Mostafa Dianati Nasab 151, Diana Dias da Silva 152, Zahra Sadat Dibaji Forooshani 153, Kerrie E Doyle 154, Tim Robert Driscoll 155, Eleonora Dubljanin 156, Bereket Duko Adema 157 158, Arielle Wilder Eagan 159 160, Aziz Eftekhari 161 162, Elham Ehsani-Chimeh 163, Maysaa El Sayed Zaki 164, Demelash Abewa Elemineh 165, Shaimaa I El-Jaafary 3, Ziad El-Khatib 166 167, Christian Lycke Ellingsen 168 169, Mohammad Hassan Emamian 170, Daniel Adane Endalew 171, Sharareh Eskandarieh 172, Pawan Sirwan Faris 173 174, Andre Faro 175, Farshad Farzadfar 176, Yousef Fatahi 177, Wubalem Fekadu 91 178, Tomas Y Ferede 179, Seyed-Mohammad Fereshtehnejad 180 181, Eduarda Fernandes 182, Pietro Ferrara 183, Garumma Tolu Feyissa 184, Irina Filip 185 186, Florian Fischer 187, Morenike Oluwatoyin Folayan 188, Masoud Foroutan 189, Joel Msafiri Francis 190, Richard Charles Franklin 191 192, Takeshi Fukumoto 193 194, Biniyam Sahiledengle Geberemariyam 195, Abadi Kahsu Gebre 196, Ketema Bizuwork Gebremedhin 197, Gebreamlak Gebremedhn Gebremeskel 198 199, Berhe Gebremichael 200, Getnet Azeze Gedefaw 201 202, Birhanu Geta 203, Mansour Ghafourifard 204, Farhad Ghamari 205, Ahmad Ghashghaee 206, Asadollah Gholamian 207 208, Tiffany K Gill 209, Alessandra C Goulart 94 210, Ayman Grada 211, Michal Grivna 212, Mohammed Ibrahim Mohialdeen Gubari 213, Rafael Alves Guimarães 214, Yuming Guo 215 216, Gaurav Gupta 217, Juanita A Haagsma 218, Nima Hafezi-Nejad 219 220, Hassan Haghparast Bidgoli 221, Brian James Hall 222, Randah R Hamadeh 223, Samer Hamidi 224, Josep Maria Haro 225 226, Md Mehedi Hasan 227, Amir Hasanzadeh 228 229, Soheil Hassanipour 230, Hadi Hassankhani 231 232, Hamid Yimam Hassen 233 234, Rasmus Havmoeller 235, Khezar Hayat 236 237, Delia Hendrie 60, Fatemeh Heydarpour 238, Martha Híjar 239 240, Hung Chak Ho 241, Chi Linh Hoang 242, Michael K Hole 243, Ramesh Holla 244, Naznin Hossain 245 246, Mehdi Hosseinzadeh 247 248, Sorin Hostiuc 249 250, Guoqing Hu 251, Segun Emmanuel Ibitoye 252, Olayinka Stephen Ilesanmi 253, Irena Ilic 156, Milena D Ilic 254, Leeberk Raja Inbaraj 255, Endang Indriasih 256, Seyed Sina Naghibi Irvani 257, Sheikh Mohammed Shariful Islam 258 259, M Mofizul Islam 260, Rebecca Q Ivers 261, Kathryn H Jacobsen 262, Mohammad Ali Jahani 263, Nader Jahanmehr 264 265, Mihajlo Jakovljevic 266, Farzad Jalilian 267, Sudha Jayaraman 268, Achala Upendra Jayatilleke 269 270, Ravi Prakash Jha 271, Yetunde O John-Akinola 252, Jost B Jonas 272 273, Nitin Joseph 274, Farahnaz Joukar 230, Jacek Jerzy Jozwiak 275, Suresh Banayya Jungari 276, Mikk Jürisson 277, Ali Kabir 278, Rajendra Kadel 279, Amaha Kahsay 95, Leila R Kalankesh 280, Rohollah Kalhor 281 282, Teshome Abegaz Kamil 283, Tanuj Kanchan 284, Neeti Kapoor 65, Manoochehr Karami 285, Amir Kasaeian 286 287, Hagazi Gebremedhin Kassaye 22, Taras Kavetskyy 288 289, Hafte Kahsay Kebede 290, Peter Njenga Keiyoro 291, Abraham Getachew Kelbore 292, Bayew Kelkay 293, Yousef Saleh Khader 294, Morteza Abdullatif Khafaie 295, Nauman Khalid 296, Ibrahim A Khalil 297, Rovshan Khalilov 298, Mohammad Khammarnia 299, Ejaz Ahmad Khan 300, Maseer Khan 301, Tripti Khanna 302 303, Habibolah Khazaie 304, Fatemeh Khosravi Shadmani 305, Roba Khundkar 306, Daniel N Kiirithio 307, Young-Eun Kim 308, Daniel Kim 309, Yun Jin Kim 310, Adnan Kisa 311, Sezer Kisa 312, Hamidreza Komaki 313 314, Shivakumar K M Kondlahalli 315, Vladimir Andreevich Korshunov 108, Ai Koyanagi 316 317, Moritz U G Kraemer 318 319, Kewal Krishan 320, Burcu Kucuk Bicer 321 322, Nuworza Kugbey 323 324, Vivek Kumar 325, Nithin Kumar 274, G Anil Kumar 326, Manasi Kumar 327 328, Girikumar Kumaresh 329, Om P Kurmi 328 330, Oluwatosin Kuti 331, Carlo La Vecchia 332, Faris Hasan Lami 333, Prabhat Lamichhane 334, Justin J Lang 335, Van C Lansingh 336 337, Dennis Odai Laryea 338, Savita Lasrado 339, Arman Latifi 340, Paolo Lauriola 341, Janet L Leasher 342, Shaun Wen Huey Lee 343 344, Tsegaye Lolaso Lenjebo 345, Miriam Levi 52 346, Shanshan Li 215, Shai Linn 347, Xuefeng Liu 348, Alan D Lopez 2 349 350, Paulo A Lotufo 351, Raimundas Lunevicius 352 353, Ronan A Lyons 354, Mohammed Madadin 355, Muhammed Magdy Abd El Razek 356, Narayan Bahadur Mahotra 357, Marek Majdan 358, Azeem Majeed 359, Jeadran N Malagon-Rojas 360 361, Venkatesh Maled 362 363, Reza Malekzadeh 364 365, Deborah Carvalho Malta 366, Navid Manafi 367 368, Amir Manafi 369, Ana-Laura Manda 370, Narayana Manjunatha 371, Fariborz Mansour-Ghanaei 230, Borhan Mansouri 372, Mohammad Ali Mansournia 373, Joemer C Maravilla 374, Lyn M March 375, Amanda J Mason-Jones 376, Seyedeh Zahra Masoumi 377, Benjamin Ballard Massenburg 131, Pallab K Maulik 378 379, Gebrekiros Gebremichael Meles 380, Addisu Melese 142, Zeleke Aschalew Melketsedik 381, Peter T N Memiah 382, Walter Mendoza 383, Ritesh G Menezes 384, Meresa Berwo Mengesha 385, Melkamu Merid Mengesha 386, Tuomo J Meretoja 387 388, Atte Meretoja 389 390, Hayimro Edemealem Merie 165, Tomislav Mestrovic 391 392, Bartosz Miazgowski 393, Tomasz Miazgowski 394, Ted R Miller 60 395, G K Mini 396 397, Andreea Mirica 398 399, Erkin M Mirrakhimov 400 401, Mehdi Mirzaei-Alavijeh 267, Prasanna Mithra 274, Babak Moazen 402 403, Masoud Moghadaszadeh 404 405, Efat Mohamadi 406, Yousef Mohammad 407, Karzan Abdulmuhsin Mohammad 408 409, Aso Mohammad Darwesh 410, Naser Mohammad Gholi Mezerji 411, Abdollah Mohammadian-Hafshejani 412, Milad Mohammadoo-Khorasani 413, Reza Mohammadpourhodki 414, Shafiu Mohammed 81 415, Jemal Abdu Mohammed 416, Farnam Mohebi 176 417, Mariam Molokhia 418, Lorenzo Monasta 419, Yoshan Moodley 420, Mahmood Moosazadeh 421, Masoud Moradi 422, Ghobad Moradi 423 424, Maziar Moradi-Lakeh 425, Farhad Moradpour 423, Lidia Morawska 426, Ilais Moreno Velásquez 427, Naho Morisaki 428, Shane Douglas Morrison 131, Tilahun Belete Mossie 91, Atalay Goshu Muluneh 429, Srinivas Murthy 430, Kamarul Imran Musa 431, Ghulam Mustafa 432 433, Ashraf F Nabhan 434 435, Ahamarshan Jayaraman Nagarajan 436 437, Gurudatta Naik 438, Mukhammad David Naimzada 439 440, Farid Najafi 441, Vinay Nangia 442, Bruno Ramos Nascimento 443, Morteza Naserbakht 425 444, Vinod Nayak 445, Duduzile Edith Ndwandwe 446, Ionut Negoi 447 448, Josephine W Ngunjiri 449, Cuong Tat Nguyen 450, Huong Lan Thi Nguyen 450, Rajan Nikbakhsh 451 452, Dina Nur Anggraini Ningrum 453 454, Chukwudi A Nnaji 446 455, Peter S Nyasulu 456, Felix Akpojene Ogbo 113, Onome Bright Oghenetega 457, In-Hwan Oh 458, Emmanuel Wandera Okunga 459, Andrew T Olagunju 460 461, Tinuke O Olagunju 462, Ahmed Omar Bali 463, Obinna E Onwujekwe 464, Kwaku Oppong Asante 465 466, Heather M Orpana 467 468, Erika Ota 469, Nikita Otstavnov 439 470, Stanislav S Otstavnov 439 471, Mahesh P A 472, Jagadish Rao Padubidri 473, Smita Pakhale 474, Keyvan Pakshir 475, Songhomitra Panda-Jonas 476, Eun-Kee Park 477, Sangram Kishor Patel 478 479, Ashish Pathak 166 480, Sanghamitra Pati 481, George C Patton 482 483, Kebreab Paulos 484, Amy E Peden 192 485, Veincent Christian Filipino Pepito 486, Jeevan Pereira 487, Hai Quang Pham 450, Michael R Phillips 488 489, Marina Pinheiro 490, Roman V Polibin 491, Suzanne Polinder 218, Hossein Poustchi 364, Swayam Prakash 492, Dimas Ria Angga Pribadi 493, Parul Puri 494, Zahiruddin Quazi Syed 97, Mohammad Rabiee 495, Navid Rabiee 496, Amir Radfar 497 498, Anwar Rafay 499, Ata Rafiee 500, Alireza Rafiei 501 502, Fakher Rahim 503 504, Siavash Rahimi 505, Vafa Rahimi-Movaghar 506, Muhammad Aziz Rahman 507 508, Ali Rajabpour-Sanati 509, Fatemeh Rajati 422, Ivo Rakovac 510, Kavitha Ranganathan 511, Sowmya J Rao 512, Vahid Rashedi 513, Prateek Rastogi 514, Priya Rathi 515, Salman Rawaf 359 516, Lal Rawal 517, Reza Rawassizadeh 518, Vishnu Renjith 519, Andre M N Renzaho 520 521, Serge Resnikoff 522, Aziz Rezapour 523, Ana Isabel Ribeiro 524, Jennifer Rickard 525 526, Carlos Miguel Rios González 527 528, Luca Ronfani 419, Gholamreza Roshandel 364 529, Anas M Saad 530, Yogesh Damodar Sabde 531, Siamak Sabour 532, Basema Saddik 533, Saeed Safari 534, Roya Safari-Faramani 535, Hamid Safarpour 536, Mahdi Safdarian 506 537, S Mohammad Sajadi 538, Payman Salamati 506, Farkhonde Salehi 539, Saleh Salehi Zahabi 540 541, Marwa R Rashad Salem 542, Hosni Salem 543, Omar Salman 544 545, Inbal Salz 546, Abdallah M Samy 547, Juan Sanabria 548 549, Lidia Sanchez Riera 550 551, Milena M Santric Milicevic 552 553, Abdur Razzaque Sarker 554, Arash Sarveazad 555, Brijesh Sathian 556 557, Monika Sawhney 558, Susan M Sawyer 559 560, Sonia Saxena 561, Mehdi Sayyah 562, David C Schwebel 563, Soraya Seedat 564, Subramanian Senthilkumaran 565, Sadaf G Sepanlou 364 365, Seyedmojtaba Seyedmousavi 566, Feng Sha 567, Faramarz Shaahmadi 568, Saeed Shahabi 569, Masood Ali Shaikh 570, Mehran Shams-Beyranvand 571, Morteza Shamsizadeh 572, Mahdi Sharif-Alhoseini 506, Hamid Sharifi 573, Aziz Sheikh 574 575, Mika Shigematsu 576, Jae Il Shin 577 578, Rahman Shiri 579, Soraya Siabani 580 581, Inga Dora Sigfusdottir 582 583, Pankaj Kumar Singh 584, Jasvinder A Singh 585 586, Dhirendra Narain Sinha 587 588, Catalin-Gabriel Smarandache 589 590, Emma U R Smith 591 592, Amin Soheili 593 594, Bija Soleymani 238, Ali Reza Soltanian 595, Joan B Soriano 596 597, Muluken Bekele Sorrie 598, Ireneous N Soyiri 599 600, Dan J Stein 601 602, Mark A Stokes 603, Mu'awiyyah Babale Sufiyan 604, Hafiz Ansar Rasul Suleria 605, Bryan L Sykes 606, Rafael Tabarés-Seisdedos 607 608, Karen M Tabb 609, Biruk Wogayehu Taddele 610, Degena Bahrey Tadesse 198 611, Animut Tagele Tamiru 612, Ingan Ukur Tarigan 256, Yonatal Mesfin Tefera 613 614, Arash Tehrani-Banihashemi 425 615, Merhawi Gebremedhin Tekle 200, Gebretsadkan Hintsa Tekulu 616, Ayenew Kassie Tesema 617, Berhe Etsay Tesfay 618, Rekha Thapar 274, Asres Bedaso Tilahune 619, Kenean Getaneh Tlaye 143, Hamid Reza Tohidinik 373 573, Roman Topor-Madry 620 621, Bach Xuan Tran 622, Khanh Bao Tran 623 624, Jaya Prasad Tripathy 625, Alexander C Tsai 626 627, Lorainne Tudor Car 628, Saif Ullah 629, Irfan Ullah 630 631, Maida Umar 632, Bhaskaran Unnikrishnan 274, Era Upadhyay 633, Olalekan A Uthman 634, Pascual R Valdez 635 636, Tommi Juhani Vasankari 637, Narayanaswamy Venketasubramanian 638 639, Francesco S Violante 640 641, Vasily Vlassov 642, Yasir Waheed 643, Girmay Teklay Weldesamuel 198, Andrea Werdecker 644 645, Taweewat Wiangkham 646, Haileab Fekadu Wolde 429, Dawit Habte Woldeyes 647, Dawit Zewdu Wondafrash 648 649, Temesgen Gebeyehu Wondmeneh 416, Adam Belay Wondmieneh 197 650, Ai-Min Wu 651, Rajaram Yadav 494, Ali Yadollahpour 652, Yuichiro Yano 653, Sanni Yaya 654, Vahid Yazdi-Feyzabadi 655 656, Paul Yip 657 658, Engida Yisma 659, Naohiro Yonemoto 660, Seok-Jun Yoon 308, Yoosik Youm 661, Mustafa Z Younis 662 663, Zabihollah Yousefi 664 665, Yong Yu 666, Chuanhua Yu 667 668, Hasan Yusefzadeh 30, Telma Zahirian Moghadam 31 669, Zoubida Zaidi 670, Sojib Bin Zaman 132 671, Mohammad Zamani 672, Maryam Zamanian 35, Hamed Zandian 669 673, Ahmad Zarei 674, Fatemeh Zare 675, Zhi-Jiang Zhang 676, Yunquan Zhang 677 678, Sanjay Zodpey 679, Lalit Dandona 2 326 350, Rakhi Dandona 2 326, Louisa Degenhardt 2 680, Samath Dhamminda Dharmaratne 2 350 681, Simon I Hay 2 350, Ali H Mokdad 2 350, Robert C Reiner Jr 2 350, Benn Sartorius 350 682, Theo Vos 2 350


 

Affiliations


Abstract

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.

Methods: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).

Findings: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).

Interpretation: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.

Keywords: burden of disease; descriptive epidemiology; global.

Conflict of interest statement

Competing interests: Dr. James reports grants from Sanofi Pasteur, outside the submitted work. Dr. Driscoll reports grants from World Health Organization, during the conduct of the study. Dr. Ivers reports grants from National Health and Medical Research Council of Australia, during the conduct of the study. Dr. Jozwiak reports personal fees from TEVA, personal fees from ALAB, personal fees from BOEHRINGER INGELHEIM, personal fees from SYNEXUS, non-financial support from SERVIER, non-financial support from MICROLIFE, non-financial support from MEDICOVER, outside the submitted work. Dr. Rakovac reports grants from World Health Organization, during the conduct of the study. Dr Shariful Islam is funded by National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. Dr. Sheikh reports grants from Health Data Research UK, outside the submitted work. Dr. Singh reports personal fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care options, Clearview healthcare partners, Putnam associates, Spherix, Practice Point communications, the National Institutes of Health and the American College of Rheumatology, and Speaker’s bureau of Simply Speaking, owns stock options in Amarin pharmaceuticals and Viking pharmaceuticals, serves on the steering committee of OMERACT, an international organization that develops measures for clinical trials and receives arm’s length funding from 12 pharmaceutical companies, serves on the FDA Arthritis Advisory Committee, is a member of the Veterans Affairs Rheumatology Field Advisory Committee, and is the editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis, outside the submitted work. Dr. Stein reports personal fees from Lundbeck, personal fees from Sun, outside the submitted work. Dr. Degenhardt reports grants from Indivior, Seqirus, Reckitt Benckiser, outside the submitted work.


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