Article(id=1324078336670049074, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202505277, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747756800000, receivedDateStr=2025-05-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614475648, onlineDateStr=2026-11-02, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614475648, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614475648, creator=13701087609, updateTime=1793614475648, updator=13701087609, issue=Issue{id=1324078175000605624, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614437103, creator='13701087609', updateTime=1793614526046, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078548130082942, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078548130082943, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=375, endPage=384, ext={EN=ArticleExt(id=1324078337135616819, articleId=1324078336670049074, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=National burden of pressure injuries from 1990 to 2021 and predicted trends for 2022-2036, China, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze trends in the disease burden of pressure injuries in China and globally from 1990 to 2021 and to project future patterns for 2022-2036.

Methods

Data on incidence, prevalence, disability-adjusted life years (DALYs), and their age-standardized rates for populations aged 0-95 years and above in China and worldwide were obtained from the GBD 2021 dataset released on May 16, 2024. Descriptive analyses were conducted to summarize the disease burden. Temporal trends were assessed using Join point regression. A decomposition analysis was applied to quantify the contributions of population growth, population aging, and epidemiological changes to variations in disease burden. Future trends were projected using a Bayesian age-period-cohort (BAPC) model.

Results

From 1990 to 2021, the numbers of incident cases, prevalent cases, and DALYs attributable to pressure injuries increased both in China and globally. In China, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR) showed upward trends, whereas global rates generally declined. The increase was more pronounced among males than females in China. Age-specific analyses indicated that incidence, prevalence, and DALY rates increased with age in 2021. According to the average annual percent change (AAPC), China’s ASIR, ASPR, and ASDR exhibited an overall rising trend. Projections using the BAPC model suggest that these age-standardized rates in China will continue to increase in the coming years.

Conclusion

The disease burden of pressure injuries in China has increased over the past three decades, with a greater rise observed among males. The burden increases progressively with age. Future projections indicate a continued upward trend, highlighting the need for effective prevention and management strategies to mitigate the disease burden and improve patient outcomes.

, authors=Jie GAO1, Miao-qian LI2, Liang-jia WANG2, Li-chun QIAO2, Xiang-yu FAN2, Shao-teng SHI2, Yuan-rong LUO1, authorsList=Jie GAO, Miao-qian LI, Liang-jia WANG, Li-chun QIAO, Xiang-yu FAN, Shao-teng SHI, Yuan-rong LUO, authorCompany=null, correspAuthors=Yuan-rong LUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078340965016382, articleId=1324078336670049074, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=1990—2021年中国压力性损伤疾病负担分析及2022—2036年疾病负担预测, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析1990—2021年中国及全球压力性损伤的疾病负担趋势,并预测2022-2036年发展态势。

方法

从全球疾病负担数据库2024年5月16日发布GBD 2021中获取中国和全球0-95岁以上人群因压力性损伤导致发病数、患病数和DALYs及其年龄标化率等指标进行描述性分析。采用Joinpoint分析疾病负担变化趋势,通过因素分解分析得到人口增长、老龄化及流行病学变化对疾病负担的影响,并运用贝叶斯年龄-时期-队列模型预测未来趋势。

结果

1990—2021年,中国和全球压力性损伤的发病数、患病数及DALYs总量均增长。中国的年龄标准化发病率(ASIR)、患病率(ASPR)和DALYs率呈上升趋势,而全球总体呈下降趋势。中国男性增幅高于女性。年龄分布上,2021年中国人群的发病率、患病率及DALYs率随年龄增长而上升。AAPC分析表明,中国ASIR、ASMR和ASDR整体呈上升趋势。中国压力性损伤的ASIR、ASPR和ASDR将在未来持续增长。

结论

1990—2021年,中国压力性损伤的疾病负担显著上升,且男性增幅大于女性。随年龄增大,疾病负担呈上升趋势。未来中国压力性损伤的疾病负担将持续上升,需采取有效的干预措施,以降低疾病负担并改善患者预后。

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高洁(1991—),女,本科,护师,研究方向:皮肤护理

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罗媛榕,E-mail:
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tableContent=null), ArticleFig(id=1324078346077873008, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=图1, caption=1990—2021年中国和全球压力性损伤的疾病负担变化及比较, figureFileSmall=jyuGtRV6zArBi8x62cPVow==, figureFileBig=6TwsfnzjW1qH8BhRcFKRGA==, tableContent=null), ArticleFig(id=1324078346275005297, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Fig.2, caption=Age- and sex-specific distribution of the pressure-injury burden in China, 2021, figureFileSmall=M7UXBpq4O5jielUiaFC4Kw==, figureFileBig=xQB+1wG9i57mVSyB4zlrIw==, tableContent=null), ArticleFig(id=1324078346363085682, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=图2, caption=2021年中国不同性别和年龄段的压力性损伤疾病负担分布特征, figureFileSmall=M7UXBpq4O5jielUiaFC4Kw==, figureFileBig=xQB+1wG9i57mVSyB4zlrIw==, tableContent=null), ArticleFig(id=1324078346430194547, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Fig.3, caption=Average annual percent change (AAPC) in pressure-injury burden indicators in China, 1990-2021, figureFileSmall=P2iufgsmSxN5B/inZyJoNg==, figureFileBig=/okKB5PoiyOn16GLTOKXBQ==, tableContent=null), ArticleFig(id=1324078346493109108, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=图3, caption=1990—2021年中国压力性损伤的疾病负担指标AAPC分析, figureFileSmall=P2iufgsmSxN5B/inZyJoNg==, figureFileBig=/okKB5PoiyOn16GLTOKXBQ==, tableContent=null), ArticleFig(id=1324078346627326837, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Fig.4, caption=Decomposition analysis of factors contributing to the change in pressure-injury burden in China, 1990-2021, figureFileSmall=aZUEf6YJxV/fk3vtTbNhTA==, figureFileBig=t2Iu5DHFS022udJrhjZUhQ==, tableContent=null), 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ArticleFig(id=1324078346975454073, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Table 1, caption=

Comparison of the disease burden of pressure injuries in China versus globally, 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
地区指标1990年(95%UI)
总体男性女性
中国发病人数163 508.67(142 891.48~184 055.10)104 094.33(90 844.30~117 001.86)59 414.33(52 044.77~67 266.99)
标化发病率18.32(16.37~20.52)22.89(20.45~25.73)13.79(12.35~15.43)
患病人数42 840.39(37 479.80~48 387.91)27 249.03(23 705.85~30 760.01)15 591.36(13 702.96~17 626.17)
标化患病率4.73(4.22~5.29)5.93(5.26~6.64)3.56(3.20~3.99)
DALYs(人年)11 965.10(7 820.54~21 703.78)7 222.27(4 607.29~14 674.56)4 742.82(3 045.70~10 107.75)
标化DALYs率1.74(1.14~3.49)2.15(1.36~5.18)1.40(0.91~3.35)
全球发病人数1 142 594.77(1 030 311.63~1 276 015.91)562 728.39(500 506.95~625 413.22)579 866.38(523 087.53~653 613.91)
标化发病率31.49(28.41~35.23)32.52(29.30~36.31)29.43(26.53~33.04)
患病人数300 442.40(270 737.67~333 578.98)148 573.84(132 750.17~165 186.86)151 868.56(135 778.56~169 194.29)
标化患病率8.24(7.38~9.17)8.53(7.70~9.47)7.68(6.87~8.62)
DALYs(人年)408 886.98(329 846.87~490 564.17)201 554.08(140 614.49~254 255.27)207 332.90(161 452.00~267 133.79)
标化DALYs率10.74(8.86~12.73)11.13(8.26~13.72)10.19(8.09~12.93)
地区指标2021年(95%UI)
总体男性女性
中国发病人数397 312.26(360 058.44~444 875.78)232 498.94(209 054.27~259 869.31)164 813.31(148 298.80~184 210.13)
标化发病率22.68(20.67~25.14)28.67(25.99~31.90)17.43(15.83~19.33)
患病人数102 938.90(92 962.79~114 787.39)60 557.42(54 281.76~67 788.81)42 381.48(38 053.84~47 196.57)
标化患病率5.88(5.32~6.50)7.46(6.747~8.29)4.50(4.08~4.98)
DALYs(人年)61 933.90(36 313.26~77 402.42)34 550.37(17 483.56~45 040.74)27 383.52(14 016.69~36 289.76)
标化DALYs率3.65(2.15~4.54)4.69(2.37~6.08)2.85(1.47~3.76)
全球发病人数2 468 317.47(2 255 077.25~2 720 436.68)1 227 224.22(1 111 878.36~1 349 395.79)1 241 093.24(1 134 081.37~1 375 353.84)
标化发病率30.27(27.65~33.27)33.34(30.48~36.61)27.05(24.74~29.93)
患病人数645 588.10(582 431.80~712 875.84)323 438.83(293 503.81~355 704.03)322 149.27(290 967.20~356 067.76)
标化患病率7.91(7.13~8.72)8.77(7.94~9.65)7.03(6.36~7.76)
DALYs(人年)803 747.40(612 264.18~903 723.23)366 854.48(239 181.06~435 670.72)436 892.91(306 212.67~523 668.39)
标化DALYs率9.69(7.40~10.88)9.70(6.41~11.42)9.58(6.70~11.51)
), ArticleFig(id=1324078347046757242, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=表1, caption=

1990年和2021年中国和全球压力性损伤的疾病负担比较

, figureFileSmall=null, figureFileBig=null, tableContent=
地区指标1990年(95%UI)
总体男性女性
中国发病人数163 508.67(142 891.48~184 055.10)104 094.33(90 844.30~117 001.86)59 414.33(52 044.77~67 266.99)
标化发病率18.32(16.37~20.52)22.89(20.45~25.73)13.79(12.35~15.43)
患病人数42 840.39(37 479.80~48 387.91)27 249.03(23 705.85~30 760.01)15 591.36(13 702.96~17 626.17)
标化患病率4.73(4.22~5.29)5.93(5.26~6.64)3.56(3.20~3.99)
DALYs(人年)11 965.10(7 820.54~21 703.78)7 222.27(4 607.29~14 674.56)4 742.82(3 045.70~10 107.75)
标化DALYs率1.74(1.14~3.49)2.15(1.36~5.18)1.40(0.91~3.35)
全球发病人数1 142 594.77(1 030 311.63~1 276 015.91)562 728.39(500 506.95~625 413.22)579 866.38(523 087.53~653 613.91)
标化发病率31.49(28.41~35.23)32.52(29.30~36.31)29.43(26.53~33.04)
患病人数300 442.40(270 737.67~333 578.98)148 573.84(132 750.17~165 186.86)151 868.56(135 778.56~169 194.29)
标化患病率8.24(7.38~9.17)8.53(7.70~9.47)7.68(6.87~8.62)
DALYs(人年)408 886.98(329 846.87~490 564.17)201 554.08(140 614.49~254 255.27)207 332.90(161 452.00~267 133.79)
标化DALYs率10.74(8.86~12.73)11.13(8.26~13.72)10.19(8.09~12.93)
地区指标2021年(95%UI)
总体男性女性
中国发病人数397 312.26(360 058.44~444 875.78)232 498.94(209 054.27~259 869.31)164 813.31(148 298.80~184 210.13)
标化发病率22.68(20.67~25.14)28.67(25.99~31.90)17.43(15.83~19.33)
患病人数102 938.90(92 962.79~114 787.39)60 557.42(54 281.76~67 788.81)42 381.48(38 053.84~47 196.57)
标化患病率5.88(5.32~6.50)7.46(6.747~8.29)4.50(4.08~4.98)
DALYs(人年)61 933.90(36 313.26~77 402.42)34 550.37(17 483.56~45 040.74)27 383.52(14 016.69~36 289.76)
标化DALYs率3.65(2.15~4.54)4.69(2.37~6.08)2.85(1.47~3.76)
全球发病人数2 468 317.47(2 255 077.25~2 720 436.68)1 227 224.22(1 111 878.36~1 349 395.79)1 241 093.24(1 134 081.37~1 375 353.84)
标化发病率30.27(27.65~33.27)33.34(30.48~36.61)27.05(24.74~29.93)
患病人数645 588.10(582 431.80~712 875.84)323 438.83(293 503.81~355 704.03)322 149.27(290 967.20~356 067.76)
标化患病率7.91(7.13~8.72)8.77(7.94~9.65)7.03(6.36~7.76)
DALYs(人年)803 747.40(612 264.18~903 723.23)366 854.48(239 181.06~435 670.72)436 892.91(306 212.67~523 668.39)
标化DALYs率9.69(7.40~10.88)9.70(6.41~11.42)9.58(6.70~11.51)
), ArticleFig(id=1324078347139031931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Table 2, caption=

Joinpoint analysis of pressure-injury burden trends in China overall and by sex, 1990-2021

, figureFileSmall=null, figureFileBig=null, tableContent=
指标(1/10万)时期总体男性
APC(95%CI)t值P值APC(95%CI)t值P值
标化发病率1990—2003-0.032(-0.095~0.031)-1.0540.304-0.149(-0.220~-0.077)-4.331<0.001
2003—20061.098(-0.078~2.288)1.9410.0661.234(-0.095~2.580)1.9310.067
2006—20097.818(6.635~9.015)14.184<0.0018.506(7.167~9.861)13.680<0.001
2009—2021-0.375(-0.439~-0.311)-12.141<0.001-0.361(-0.434~-0.289)-10.348<0.001
标化患病率1990—2003-0.056(-0.116~0.004)-1.9400.066-0.163(-0.232~-0.093)-4.878<0.001
2003—20061.094(-0.034~2.234)2.0160.0571.229(-0.055~2.530)1.9900.060
2006—20097.898(6.757~9.051)14.870<0.0018.648(7.341~9.971)14.255<0.001
2009—2021-0.337(-0.397~-0.277)-11.664<0.001-0.328(-0.398~-0.258)-9.706<0.001
标化DALYs率1990—20049.889(8.751~11.038)18.847<0.00110.929(9.551~12.325)17.257<0.001
2004—20100.086(-3.848~4.181)0.0450.9650.548(-2.336~3.518)0.3910.700
2010—2016-6.464(-9.408~-3.424)-4.345<0.001-6.046(-9.142~-2.845)-3.8710.001
2016—20211.590(-1.448~4.722)1.0800.2921.528(-1.720~4.883)0.9700.343
指标(1/10万)时期女性   
APC(95%CI)t值P值
标化发病率1990—20030.198(0.138~0.257)6.939<0.001   
 2003—20061.181(0.064~2.310)2.1990.039   
 2006—20097.691(6.546~8.848)14.421<0.001   
 2009—2021-0.414(-0.476~-0.353)-13.976<0.001   
标化患病率1990—20030.159(0.105~0.213)6.100<0.001   
 2003—20061.184(0.142~2.237)2.3650.028   
 2006—20097.716(6.657~8.786)15.639<0.001   
 2009—2021-0.369(-0.426~-0.313)-13.612<0.001   
标化DALYs率1990—20049.865(8.830~10.910)20.673<0.001   
 2004—20100.488(-2.894~3.989)0.2960.770   
 2010—2016-7.255(-9.822~-4.616)-5.582<0.001   
 2016—20211.518(-1.178~4.289)1.1640.257   
), ArticleFig(id=1324078347231306620, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=表2, caption=

1990—2021年中国总体和不同性别人群的压力性损伤Jointpoint负担趋势分析

, figureFileSmall=null, figureFileBig=null, tableContent=
指标(1/10万)时期总体男性
APC(95%CI)t值P值APC(95%CI)t值P值
标化发病率1990—2003-0.032(-0.095~0.031)-1.0540.304-0.149(-0.220~-0.077)-4.331<0.001
2003—20061.098(-0.078~2.288)1.9410.0661.234(-0.095~2.580)1.9310.067
2006—20097.818(6.635~9.015)14.184<0.0018.506(7.167~9.861)13.680<0.001
2009—2021-0.375(-0.439~-0.311)-12.141<0.001-0.361(-0.434~-0.289)-10.348<0.001
标化患病率1990—2003-0.056(-0.116~0.004)-1.9400.066-0.163(-0.232~-0.093)-4.878<0.001
2003—20061.094(-0.034~2.234)2.0160.0571.229(-0.055~2.530)1.9900.060
2006—20097.898(6.757~9.051)14.870<0.0018.648(7.341~9.971)14.255<0.001
2009—2021-0.337(-0.397~-0.277)-11.664<0.001-0.328(-0.398~-0.258)-9.706<0.001
标化DALYs率1990—20049.889(8.751~11.038)18.847<0.00110.929(9.551~12.325)17.257<0.001
2004—20100.086(-3.848~4.181)0.0450.9650.548(-2.336~3.518)0.3910.700
2010—2016-6.464(-9.408~-3.424)-4.345<0.001-6.046(-9.142~-2.845)-3.8710.001
2016—20211.590(-1.448~4.722)1.0800.2921.528(-1.720~4.883)0.9700.343
指标(1/10万)时期女性   
APC(95%CI)t值P值
标化发病率1990—20030.198(0.138~0.257)6.939<0.001   
 2003—20061.181(0.064~2.310)2.1990.039   
 2006—20097.691(6.546~8.848)14.421<0.001   
 2009—2021-0.414(-0.476~-0.353)-13.976<0.001   
标化患病率1990—20030.159(0.105~0.213)6.100<0.001   
 2003—20061.184(0.142~2.237)2.3650.028   
 2006—20097.716(6.657~8.786)15.639<0.001   
 2009—2021-0.369(-0.426~-0.313)-13.612<0.001   
标化DALYs率1990—20049.865(8.830~10.910)20.673<0.001   
 2004—20100.488(-2.894~3.989)0.2960.770   
 2010—2016-7.255(-9.822~-4.616)-5.582<0.001   
 2016—20211.518(-1.178~4.289)1.1640.257   
), ArticleFig(id=1324078347310998397, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Table 3, caption=

Average annual percent change (AAPC) in pressure-injury burden in China overall and by sex, 1990-2021

, figureFileSmall=null, figureFileBig=null, tableContent=
指标(1/10万)总体男性
AAPC%(95%CI)t值P值AAPC%(95%CI)t值P值
标化发病率0.678(0.526~0.829)8.785<0.0010.709(0.538~0.880)8.152<0.001
标化患病率0.689(0.544~0.835)9.309<0.0010.728(0.562~0.894)8.629<0.001
标化DALYs率3.289(2.125~4.467)5.596<0.0013.573(2.424~4.735)6.165<0.001
指标(1/10万)女性   
AAPC%(95%CI)t值P值
标化发病率0.756(0.610~0.901)10.229<0.001
标化患病率0.759(0.625~0.894)11.077<0.001
标化DALYs率3.178(2.161~4.205)6.188<0.001
), ArticleFig(id=1324078348976137086, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=表3, caption=

1990—2021年中国总体和不同性别人群的压力性损伤的AAPC

, figureFileSmall=null, figureFileBig=null, tableContent=
指标(1/10万)总体男性
AAPC%(95%CI)t值P值AAPC%(95%CI)t值P值
标化发病率0.678(0.526~0.829)8.785<0.0010.709(0.538~0.880)8.152<0.001
标化患病率0.689(0.544~0.835)9.309<0.0010.728(0.562~0.894)8.629<0.001
标化DALYs率3.289(2.125~4.467)5.596<0.0013.573(2.424~4.735)6.165<0.001
指标(1/10万)女性   
AAPC%(95%CI)t值P值
标化发病率0.756(0.610~0.901)10.229<0.001
标化患病率0.759(0.625~0.894)11.077<0.001
标化DALYs率3.178(2.161~4.205)6.188<0.001
), ArticleFig(id=1324078349064217471, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=EN, label=Table 4, caption=

BAPC-projected age-standardized incidence (ASIR), prevalence (ASPR), and death rates (ASDR) for pressure injuries in China, 2022-2036

, figureFileSmall=null, figureFileBig=null, tableContent=
年份ASIR预测值(95%CI)(1/10万)ASPR预测值(95%CI)
(1/10万)
ASDR预测值(95%CI)
(1/10万)
20224.95(4.62~5.28)1.27(1.19~1.35)0.83(0.75~0.91)
20235.00(4.59~5.40)1.28(1.18~1.38)0.87(0.71~1.02)
20245.04(4.54~5.54)1.29(1.16~1.42)0.90(0.65~1.16)
20255.08(4.45~5.70)1.30(1.36~1.47)0.94(0.56~1.31)
20265.11(4.35~5.88)1.31(1.10~1.51)0.98(0.46~1.50)
20275.15(4.23~6.07)1.31(1.06~1.57)1.02(0.33~1.71)
20285.18(4.09~6.27)1.32(1.02~1.62)1.06(0.18~1.94)
20295.21(3.94~6.48)1.33(0.98~1.68)1.10(0.01~2.20)
20305.23(3.77~6.69)1.33(0.93~1.73)1.15(-0.18~2.48)
20315.26(3.59~6.92)1.34(0.88~1.80)1.19(-0.41~2.80)
20325.28(3.40~7.16)1.34(0.82~1.86)1.24(-0.67~3.16)
20335.30(3.20~7.41)1.35(0.76~1.93)1.29(-0.95~3.54)
20345.32(2.98~7.91)1.35(0.70~2.00)1.34(-1.27~3.96)
20355.33(2.75~7.91)1.35(0.64~2.06)1.39(-1.62~4.41)
20365.34(2.52~8.17)1.36(0.57~2.13)1.45(-2.01~4.92)
), ArticleFig(id=1324078349198435200, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078336670049074, language=CN, label=表4, caption=

2022—2036年中国压力性损伤的ASIR、ASPR和ASDR的BAPC预测值

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年份ASIR预测值(95%CI)(1/10万)ASPR预测值(95%CI)
(1/10万)
ASDR预测值(95%CI)
(1/10万)
20224.95(4.62~5.28)1.27(1.19~1.35)0.83(0.75~0.91)
20235.00(4.59~5.40)1.28(1.18~1.38)0.87(0.71~1.02)
20245.04(4.54~5.54)1.29(1.16~1.42)0.90(0.65~1.16)
20255.08(4.45~5.70)1.30(1.36~1.47)0.94(0.56~1.31)
20265.11(4.35~5.88)1.31(1.10~1.51)0.98(0.46~1.50)
20275.15(4.23~6.07)1.31(1.06~1.57)1.02(0.33~1.71)
20285.18(4.09~6.27)1.32(1.02~1.62)1.06(0.18~1.94)
20295.21(3.94~6.48)1.33(0.98~1.68)1.10(0.01~2.20)
20305.23(3.77~6.69)1.33(0.93~1.73)1.15(-0.18~2.48)
20315.26(3.59~6.92)1.34(0.88~1.80)1.19(-0.41~2.80)
20325.28(3.40~7.16)1.34(0.82~1.86)1.24(-0.67~3.16)
20335.30(3.20~7.41)1.35(0.76~1.93)1.29(-0.95~3.54)
20345.32(2.98~7.91)1.35(0.70~2.00)1.34(-1.27~3.96)
20355.33(2.75~7.91)1.35(0.64~2.06)1.39(-1.62~4.41)
20365.34(2.52~8.17)1.36(0.57~2.13)1.45(-2.01~4.92)
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1990—2021年中国压力性损伤疾病负担分析及2022—2036年疾病负担预测
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高洁 1 , 李淼芊 2 , 王良佳 2 , 乔利春 2 , 范翔宇 2 , 史绍腾 2 , 罗媛榕 1
现代预防医学 | 疾病预防控制 2026,53(2): 375-384
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现代预防医学 |疾病预防控制 2026 , 53 (2) : 375 -384
1990—2021年中国压力性损伤疾病负担分析及2022—2036年疾病负担预测
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高洁1, 李淼芊2, 王良佳2, 乔利春2, 范翔宇2, 史绍腾2, 罗媛榕1
作者信息
  • 1.南京医科大学附属脑科医院,江苏 南京 210029
  • 2.西安交通大学医学部公共卫生学院
通讯作者:
罗媛榕,E-mail:
作者简介:

高洁(1991—),女,本科,护师,研究方向:皮肤护理

National burden of pressure injuries from 1990 to 2021 and predicted trends for 2022-2036, China
Jie GAO1, Miao-qian LI2, Liang-jia WANG2, Li-chun QIAO2, Xiang-yu FAN2, Shao-teng SHI2, Yuan-rong LUO1
Affiliations
  • Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, China
出版时间: 2026-01-25 doi: 10.20043/j.cnki.MPM.202505277
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目的

分析1990—2021年中国及全球压力性损伤的疾病负担趋势,并预测2022-2036年发展态势。

方法

从全球疾病负担数据库2024年5月16日发布GBD 2021中获取中国和全球0-95岁以上人群因压力性损伤导致发病数、患病数和DALYs及其年龄标化率等指标进行描述性分析。采用Joinpoint分析疾病负担变化趋势,通过因素分解分析得到人口增长、老龄化及流行病学变化对疾病负担的影响,并运用贝叶斯年龄-时期-队列模型预测未来趋势。

结果

1990—2021年,中国和全球压力性损伤的发病数、患病数及DALYs总量均增长。中国的年龄标准化发病率(ASIR)、患病率(ASPR)和DALYs率呈上升趋势,而全球总体呈下降趋势。中国男性增幅高于女性。年龄分布上,2021年中国人群的发病率、患病率及DALYs率随年龄增长而上升。AAPC分析表明,中国ASIR、ASMR和ASDR整体呈上升趋势。中国压力性损伤的ASIR、ASPR和ASDR将在未来持续增长。

结论

1990—2021年,中国压力性损伤的疾病负担显著上升,且男性增幅大于女性。随年龄增大,疾病负担呈上升趋势。未来中国压力性损伤的疾病负担将持续上升,需采取有效的干预措施,以降低疾病负担并改善患者预后。

压力性损伤  /  疾病负担  /  AAPC分析  /  BAPC预测
Objective

To analyze trends in the disease burden of pressure injuries in China and globally from 1990 to 2021 and to project future patterns for 2022-2036.

Methods

Data on incidence, prevalence, disability-adjusted life years (DALYs), and their age-standardized rates for populations aged 0-95 years and above in China and worldwide were obtained from the GBD 2021 dataset released on May 16, 2024. Descriptive analyses were conducted to summarize the disease burden. Temporal trends were assessed using Join point regression. A decomposition analysis was applied to quantify the contributions of population growth, population aging, and epidemiological changes to variations in disease burden. Future trends were projected using a Bayesian age-period-cohort (BAPC) model.

Results

From 1990 to 2021, the numbers of incident cases, prevalent cases, and DALYs attributable to pressure injuries increased both in China and globally. In China, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR) showed upward trends, whereas global rates generally declined. The increase was more pronounced among males than females in China. Age-specific analyses indicated that incidence, prevalence, and DALY rates increased with age in 2021. According to the average annual percent change (AAPC), China’s ASIR, ASPR, and ASDR exhibited an overall rising trend. Projections using the BAPC model suggest that these age-standardized rates in China will continue to increase in the coming years.

Conclusion

The disease burden of pressure injuries in China has increased over the past three decades, with a greater rise observed among males. The burden increases progressively with age. Future projections indicate a continued upward trend, highlighting the need for effective prevention and management strategies to mitigate the disease burden and improve patient outcomes.

Pressure injuries  /  Disease burden  /  AAPC analysis  /  BAPC prediction
高洁, 李淼芊, 王良佳, 乔利春, 范翔宇, 史绍腾, 罗媛榕. 1990—2021年中国压力性损伤疾病负担分析及2022—2036年疾病负担预测. 现代预防医学, 2026 , 53 (2) : 375 -384 . DOI: 10.20043/j.cnki.MPM.202505277
Jie GAO, Miao-qian LI, Liang-jia WANG, Li-chun QIAO, Xiang-yu FAN, Shao-teng SHI, Yuan-rong LUO. National burden of pressure injuries from 1990 to 2021 and predicted trends for 2022-2036, China[J]. Modern Preventive Medicine, 2026 , 53 (2) : 375 -384 . DOI: 10.20043/j.cnki.MPM.202505277
压力性损伤(Pressure injuries/ulcers)是指皮肤及/或深部组织因长期受压或剪切力作用而发生的局部损伤,病变可表现为完整皮肤下的损伤或开放性伤口,并伴有疼痛,严重影响患者的生活质量[1]。该病在临床上曾被称为褥疮(Decubitus ulcer)或压疮(Pressure ulcer),对全球医疗体系和社会经济造成沉重负担[2-4]。研究表明,压力性损伤的总体发生率约为12%,在重症监护室患者中可高达26.6%[3, 5]。在美国,每年约有6万人因压力性损伤死亡,医疗支出高达178亿美元[2]。全球疾病负担研究(Global Burden of Disease, GBD)数据显示,1990—2019年,全球压力性损伤的年龄标准化患病率、发病率和伤残损失生命年率整体呈下降趋势。然而该疾病负担随着年龄增长显著增加,并在95岁左右达到峰值[6]。此外,欧洲15个国家的年龄标准化发病率呈上升趋势,而高收入北美、中拉丁美洲和热带拉丁美洲是全球21个GBD地区中患病率和发病率最高的地区[7]。
尽管全球范围内已有大量关于压力性损伤疾病负担的研究,但目前尚缺乏针对中国长期疾病负担变化趋势的系统分析。鉴于中国人口老龄化加剧,压力性损伤的防治面临更大挑战,亟需基于大规模流行病学数据的深入研究,以明确该疾病在中国的流行趋势及未来变化模式。
更为重要的是,国家卫生健康委《2022—2025 年医疗质量安全改进目标》已将‘降低住院患者Ⅱ期及以上压力性损伤发生率’列为核心指标。本研究提供的分年龄、分性别 DALYs 和 YLDs 预测值,可直接用于量化该政策目标的潜在收益缺口,并为后续在老年护理机构及居家照护场景中配置专科护士、压疮预警系统等资源提供优先排序依据。
因此,本研究利用GBD 2021数据库,分析1990—2021年中国压力性损伤的发病率、患病率及伤残调整生命年(Disability adjusted life years,DALYs)变化趋势,并采用贝叶斯年龄—时期—队列(Bayesian age-period-cohort,BAPC)模型预测2022—2036年压力性损伤的疾病负担发展趋势。研究结果有望为中国压力性损伤的预防与控制提供科学依据,为卫生政策制定和医疗资源配置提供参考,以降低该疾病对个体健康和社会经济的影响。
本研究数据来源于GBD 2021年的公开数据[8],疾病原因选择“Decubitus ulcer”(ICD-10:L89),地区选择“China”,指标选择发病数、患病数和DALYs数及其年龄标化率,以及各指标的95%不确定区间(Uncertain interval, UI),并根据性别、5岁为单位的年龄分组进行分析。此外,我们已在讨论部分增加对GBD中国数据来源与质量的认识,包括本土证据和模型估算的组成,并提出IHME会经由本土文献、调查结果和实际死因系统进行校准,最终通过CODEm和DisMod-MR 2.1模型应用定量化结果。
本研究使用Excel 2019对相关数据进行整理,并利用R语言(4.4.2)和JD_GBDR2021_V2.5.3进行数据可视化。提取中国及全球0~95岁及以上人群因压力性损伤导致的发病数、患病数及伤残调整寿命年(DALYs),并获取其年龄标化发病率(Age-standardized incidence rate, ASIR)、年龄标化患病率(Age-standardized prevalence rate, ASPR)及年龄标化DALYs率(Age-standardized disability-adjusted life years rate, ASDR),对1990—2021年的疾病负担进行描述性分析。
采用 Joinpoint 回归模型 分析时间趋势,计算各年度变化百分比(Annual percent change, APC)及平均年度变化百分比(Average annual percent change, AAPC)及其 95% 置信区间(Confidence interval, CI)。该模型能够识别年龄标化率在特定年份的变化趋势。本研究将显著性水平设定为α=0.05。
利用Das Gupta分解法按性别分层,将人口老龄化、人口增长和流行病学变化三个因素纳入分析,对比1990–2021年压力性损伤疾病负担的变化及各因素贡献。
基于 GBD 2021 最新数据,采用 贝叶斯年龄-时期-队列模型(Bayesian age–period–cohort model, BAPC)对未来趋势进行预测。考虑到长期预测可能因队列效应和时期效应导致可靠性下降,本研究选择预测 2022—2036 年中国人群压力性损伤的年龄标化发病率(ASIR)、年龄标化患病率(ASPR)及年龄标化DALYs率(ASDR)。
1990—2021年,中国和全球压力性损伤的总体发病人数、患病人数及DALYs数均呈上升趋势。在观察期内,相较于1990年,中国的年龄标化发病率(ASIR)、年龄标化患病率(ASPR)及年龄标化 DALYs 率(ASDR)的平均年度变化百分比(EAPC)均为正值,而全球总体变化则呈下降趋势。2021年,中国压力性损伤的发病数为39.73万例,患病数为10.29万例,DALYs数达6.19万人年;同期,全球压力性损伤的发病数为246.83万例,患病数为64.56万例,DALYs数达80.37万人年。此外,2021年中国的ASIR、ASPR和ASDR,较1990年分别增长了23.79%、24.31%和109.77%,增幅明显。而全球ASIR、ASPR和ASDR较1990年分别下降3.87%、4.00%和9.77%。整体来看,中国压力性损伤的疾病负担增幅远超全球水平,呈现显著的上升趋势。
性别差异分析显示,中国男性的压力性损伤负担远高于女性,且增幅更为明显。其ASIR、ASPR和ASDR均约为女性的1.6倍。在观察期间内,全球范围内女性的发病数和DALYs数均高于男性,但男性的年龄标准化率仍高于女性;值得注意的是,自2007年起,全球男性的患病人数已超过女性并持续保持这一趋势。。这表明,尽管全球女性的绝对病例数较高,但在校正年龄因素后,男性的压力性损伤风险更大(见表1和图1)。
2021年,中国男性的压力性损伤发病数、患病数及DALYs数均高于女性,且随年龄增长病例数和人年先增加后减少,而发病率、患病率及DALYs率则随着年龄增长持续上升(见图2)。从年龄分布来看,男性和女性的发病数和患病数均在80~89岁组达到峰值,其中,男性发病数为23 890例,女性为24 381例,男性患病数为6 078例,女性为6 175例。发病率方面,男性从0.60/10万增长至1 704.29/10万,女性从0.62/10万增长至1 543.50/10万。患病率呈现类似趋势,男性从0.16/10万升至449.40/10万,女性从0.17/10万升至399.53/10万。值得注意的是,75~79岁组后,男性和女性的发病率均出现显著增长,增幅较大,且男性始终高于女性。此外,随着年龄的增长,男性的DALYs率从0.04/10万上升至295.64/10万,女性则从0.03/10万上升至364.77/10万。值得关注的是,DALYs率在70~74岁组后明显升高,且其拐点较发病率和患病率有所前移,提示高龄个体因压力性损伤导致的健康损失更为严重。
1990至2021年间,中国ASIR、ASPR和ASDR整体呈上升趋势,AAPC分别为0.678%(95% CI: 0.526~0.829)、0.689%(95% CI: 0.544~0.835)和3.289%(95% CI: 2.125~4.467),P值均小于0.001。从性别角度分析,中国男性和女性的ASIR、ASPR和ASDR的AAPC变化趋势和总体情况相似。男性的ASIR、ASPR和ASDR的AAPC分别为0.709%(95% CI: 0.538~0.880)、0.728%(95% CI: 0.562~0.894)和3.573%(95% CI: 2.424~4.735),而女性分别为0.756%(95% CI: 0.610~0.901)、0.759%(95% CI: 0.625~0.894)和3.178%(95% CI: 2.161~4.205)(见表2、表3和图3)。
因素分解的结果表明,总体发病人数、患病人数和DALYs数的增加主要归因于人口老龄化,其次是人口数量的增加和流行病学特征的改变。1990—2021年,人口老龄化、人口增长和流行病学变化对压力性损伤发病人数的贡献比例分别为64.96%、21.22%和13.81%;对压力性损伤患病人数的贡献比例分别为、64.18%、21.47%、14.35%;对压力性损伤DALYs数的贡献比例分别为46.54%、12.09%、41.37%。不同性别的因素分解结果与总人群相似(见图4)。
BAPC模型预测结果显示,2022—2036年中国压力性损伤的ASIR、ASPR和ASDR将逐年持续上升。相较于2022年,2036年中国压力性损伤的发病人数将增至715 457.17人,ASIR将从4.95/10万(95% CI: 4.62~5.28)增加至5.34/10万(95% CI: 2.52~8.17),上升7.87%。患病人数预计将增至182 401.66人,ASPR从1.27/10万(95% CI: 1.19~1.35)升至1.36/10万(95% CI: 0.57~2.13),上升7.08%。此外,DALYs数将增加至419 496.49人年,ASDR从0.83/10万(95% CI: 0.75~0.91)升至1.45/10万(95% CI: -2.01~4.92),增长幅度达到74.70%(见表4和图5)。
本研究对1990至2021年中国压力性损伤的流行趋势进行了深入分析,并基于BAPC模型预测了未来的疾病负担趋势。结果表明,中国压力性损伤的发病、患病和DALYs数均呈现逐年上升的趋势,反映出这一疾病负担在我国逐渐加重。通过分析不同时间段的变化及性别差异,本研究揭示了压力性损伤流行趋势的多样性,有望为未来的公共卫生政策和干预措施提供了重要的参考依据。
压力性损伤的流行趋势受多种因素的影响。因素分解分析表明压力性损伤的疾病负担主要由人口老龄化驱动,其次是人口增长。随着我国人口老龄化的加剧,老年群体的比例逐年增加,而老年人是压力性损伤的高发人群[8-9]。压力性损伤的发病率、患病率和DALYs率在60岁以上的群体中显著升高。老年人群体由于生理功能的退化,如骨质疏松[10]、肌肉萎缩[11]和行动能力下降[12],更容易发生摔倒、压伤等事件。这些生理特点使得老年人对外界刺激的反应更加迟缓,从而增加了压力性损伤发生的风险。此外,老年人常伴有多种慢性疾病,如糖尿病[13]、高血压[14]等,这些疾病往往使其恢复能力下降,加重了压力性损伤的健康负担。因此,随着我国老龄化社会进程加快,压力性损伤的负担预计将持续增加。
性别差异在压力性损伤的流行趋势中也起到了重要作用。研究发现,男性的发病率和死亡率普遍高于女性,且增幅较大。根据社会性别角色的不同,男性群体的生活和工作方式可能是导致其发病率较高的一个重要因素。男性常从事体力劳动较强的职业[15],如建筑工地工人[16]、司机[17]等,这些工作环境中的长时间站立或重体力劳动增加了他们患上压力性损伤的风险。而女性群体虽然在某些工作中也存在较高的工作强度,但其整体的生活和工作环境相对较轻,可能因此呈现较低的发病率和死亡率。交互作用分析进一步支持了这一观点:2003—2010年间,男性的ASIR和ASPR增长幅度明显高于女性。这提示男性在此阶段面临更大的健康风险。因此,男性群体的职业健康教育和劳动保护措施,特别是在高风险行业中的干预,将是减轻压力性损伤负担的有效途径。
研究中的时间段分析揭示了压力性损伤的疾病负担在不同年份呈现明显波动。2003—2009年间,压力性损伤的发病率和患病率急剧上升,尤其在2006—2009年间,增幅最为显著。此期间的急剧上升,可能与我国经济快速发展和城市化进程加速有关,更多的高危人群可能暴露在不良工作环境或生活条件下[18]。而2010—2016年期间发病率和患病率逐步下降,其中 ASDR 的下降尤为明显。这个变化趋势可能得益于国家层面对健康问题的关注加强以及医疗技术的逐步进步[19]。随着人们健康意识的提升,公共卫生干预措施如早期筛查、医疗资源的合理配置和治疗水平的提高,可能在一定程度上缓解了压力性损伤带来的健康负担[20]。
此外,本研究的预测结果显示,从2022年到2036年,压力性损伤的负担将持续增长,特别是在老年群体中,发病率、患病率和DALYs数的上升幅度较大。这一预测反映了我国压力性损伤的负担将进一步加重,可能是由于人口老龄化进程的推进和慢性病的增多。尽管医疗水平不断提升,但老年群体的增多及其特殊生理特点使得该群体的健康问题愈加复杂[21]。因此,未来应针对老年群体加强健康管理,制定更为科学和针对性的干预措施,尤其是在预防和早期干预方面。
从公共卫生政策的角度来看,随着压力性损伤负担的上升,亟需加大在老年群体中的健康管理力度,尤其是高风险人群的筛查和干预[22]。此外,针对性别差异的干预措施同样重要。男性群体在某些高风险行业中的暴露较多,因此在这些行业中应加强劳动保护和健康教育,尤其是针对长期从事重体力劳动的工人,应定期进行健康检查和干预。同时,社会应加强老年人群体的生活环境改善,推广适合老年人的运动和康复活动,增强其身体素质和防摔倒能力,减少压力性损伤的发生。
本研究有一定局限性,对中国压力性损伤疾病负担及未来趋势的估计依赖 GBD 2021 的数据,缺乏全国范围内的原始流行病学调查或长期照护机构登记数据。因此,结果的不确定性区间(UI)较大,尤其是对≥80 岁居家失能人群的患病率可能低估。因此,本研究所得疾病负担只能视为宏观趋势参考,后续需结合国家老年照护调查或医保真实世界数据进一步验证。
  • 南京脑科医院科研课题(HLKT-2024-001)
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2026年第53卷第2期
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doi: 10.20043/j.cnki.MPM.202505277
  • 接收时间:2025-05-21
  • 首发时间:2026-11-02
  • 出版时间:2026-01-25
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  • 收稿日期:2025-05-21
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    1.南京医科大学附属脑科医院,江苏 南京 210029
    2.西安交通大学医学部公共卫生学院

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