Global, Regional, and National Burden of Decubitus ulcers from 1990 to 2021: Findings from the 2021 Global Burden of Disease Study
Authors: Wang Xiaoqiong , Jiang Yongpo , Zhang Wenyuan , Zhao Weili , Xu Yinghe , Wang Nan 
Published: July 2024

Abstract

Background
Decubitus ulcers are largely preventable, but due to varying levels of attention to decubitus ulcers around the world, many patients still suffer from them. This study aims to analyze the trends and disease burden of decubitus ulcers globally, across 21 regions, and in 204 countries from 1990 to 2021.
Methods
Using the Global Burden of Disease (GBD) methodology standardized approach, we utilize epidemiological data on the incidence rate, mortality rate, and disability-adjusted life years (DALYs)of decubitus ulcers to accurately quantify the health burden caused by decubitus ulcers. By stratifying the data by region, age, and sex, we can conduct an in-depth analysis to gain insights into the impact of decubitus ulcers.
Results
As of 2021, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized rate of disability-adjusted life years (ASDR) for decubitus ulcers globally have exhibited an overall declining trend. The trends in males and females are generally consistent with the overall trend, the trends vary across different Sociodemographic Index (SDI) regions. In high SDI regions, the ASIR, ASMR, and ASDR of decubitus ulcers are all declining. The ASIR of decubitus ulcers is higher than expected in both low and high SDI regions, while it is lower than expected in medium SDI regions. The ASMR and ASDR are lower than expected in all SDI regions. In 2021, globally, the incident rate, death rate, DALYs rate of decubitus ulcers increase with age. The incident rate, death rate, DALYs rate for both sexes are highest in the age group of ≥ 95 years. The number of incident cases for both males and females increases with age until before 84 and 89 years, respectively, and then starts to decline. The ASMR for males and females is highest in the age group of ≥ 95 years, with the highest number of deaths occurring in the 85–89 age group. The DALYs for males and females are highest in the 65–69 and 80–84 age groups, respectively. These findings indicate that while past prevention and control measures for decubitus ulcers have been effective, the prevention of decubitus ulcers still poses significant challenges with the aging population.
Conclusion
Research results indicate that there has been some improvement in the global burden of decubitus ulcers compared to before. Various indicators related to the burden of decubitus ulcers show a decreasing trend. However, this decline is not uniform across different countries and regions, and the incident rate varies among different age groups. In regions with a high SDI, the effectiveness of decubitus ulcers prevention is notable, whereas in lower SDI regions, the burden is heavier, particularly among elderly individuals who exhibit higher incidence rates of decubitus ulcers. Future emphasis in decubitus ulcers prevention may need to be directed towards addressing the needs of lower SDI regions and the elderly population.