FRI0552 GLOBAL, REGIONAL, AND NATIONAL BURDEN OF LOW BACK PAIN, 1990-2019: A SYSTEMATIC ANALYSIS FOR THE GLOBAL BURDEN OF DISEASE STUDY 2019
Authors: D. Wu, X. Wu, J. Wu, L. S. Tam, J. Gu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Low back pain (LBP) has become a major public health problem worldwide although the burden and underlying causes differ across locations and demographic groups. Objectives: To report the distribution, trend and risk factor in the burden of LBP from the Global Burden of Disease Study 2019 (GBD 2019). Methods: Based on GBD 2019, decomposition analyses were performed according to gender, age, geography and sociodemographic index (SDI). The number and age standardized rate of incidence, prevalence and disability adjusted life years (DALYs) with 95% uncertainty intervals (UI) were calculated. Results: In 2019, female patients have a slightly higher number of prevalence (17%), incidence (15%) and DALYs (16%) than male patients. Out of twenty 5-year age group, the number of incidences, prevalence, DALYs peak at 50-54 age group, while the rate of incidence, prevalence, DALYs peaked at 80-84 age group. From 5 SDI regions, the highest number and age-standardized rate of incidence, prevalence, DALYs were observed in middle and high SDI region, respectively. Considering 21 GBD regions, the highest number of incidence, prevalence, and DALYs were observed in East Asia, while the highest age standardized rate of incidence, prevalence and DALYs all found in Central Europe, High-income North America, High-income North America, respectively. In 204 countries and territories, the top 3 highest number of incidence, prevalence and DALYs were from China, India, United States of America. The top 3 highest age-standardized rate of prevalence, and DALYs were Georgia, United States of America, Denmark, while top 3 highest age-standardized rate of incidence were Poland, Vanuatu, Romania. From 1990 to 2019, globally, the number of incidence, prevalence, DALYs increased by 50%, 47%, 47% to 223,738,363 (95%UI 197,935,799-253,300,243), 569,089,727 (95% UI 505,632,980-641,256,710), 63,533,528 (95%UI 44,883,714-84,975,210), while age standardized rate of incidence, prevalence and DALYs decreased by 13%, 16%, 16% to 2,750 (95%UI 2,427-3,108), 6,974 (95%UI 6,192-7,862), 778 (95%UI 548-1,043). In 5 SDI regions, low SDI region has the highest percentage increases in number of incidence, prevalence and DALYs, the highest percentage decrease in age standardized rate of incidence, prevalence and DALYs were observed in High-middle SDI. In 21 GBD regions, the highest percentage increase in number of incidence, prevalence and DALYs were found in Central Sub-Saharan Africa, while East Asia has the highest percentage decrease in age standardized rate of incidence, prevalence and DALYs. In 204 countries and territories, the greatest percentage increase in number rate of incidence, prevalence, and DALYs were observed in Qatar, while the greatest percentage decrease in age-standardized rate of incidence, prevalence, and DALYs were found in China. In 2019, three risk factors account for 40% (95%UI:36%, 40%) DALYs due to LBP, including smoking (16%, 95%UI:12%, 20%), high body-mass index (7%,95%UI: 4%, 10%), occupational ergonomic factors (24%, 95%UI:22%, 26%). Conclusion: There is significant varied and increased disease burden of LBP by gender, age and geography, partly due to population growth and ageing. The age-standardized rate of prevalence, incidence and DALYs are decreasing, especially in countries such as China and India. Cost effective interventions targeted risk factors are required to minimize the ongoing burden of this condition. References: [1] Hoy D, et al. Ann Rheum Dis. 2014;73(6):968–974. [2] Maher C, et al. Lancet. 2017;389(10070):736–747. [3] GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Lancet. 2018;392(10159):1789–1858. [4] GBD 2017 Risk Factor Collaborators. Lancet. 2018;392(10159):1923–1994. Disclosure of Interests: Dongze WU: None declared, Xinyu WU: None declared, Jialing Wu: None declared, Lai-Shan Tam Grant/research support from: Janssen, Pfizer, Novartis, Speakers bureau: Abbvie, Lilly, Sanofi, Jieruo Gu: None declared