Objective To characterize the disease burden and trends of road injury-related traumatic brain injury (RI-TBI) in China from 1990 to 2021.

Methods Using data from the Global Burden of Disease Study 2021, the RI-TBI incidence, prevalence, and years lived with disability (YLD) for China and its 33 provincial-level administrative divisions between 1990 and 2021 were estimated. Temporal trends were evaluated by calculating the estimated annual percentage change (EAPC) in age-standardized rates. Stratified analysis was conducted by age, gender, province, and road-user category.

Results In 2021, the age-standardized incidence rate (ASIR) of RI-TBI for China was 86.63 per 100,000, and the age-standardized prevalence rate (ASPR) was 197.23 per 100,000, age-standardized YLD rate (ASYR) was 29.70 per 100,000 person-years. From 1990 to 2021, the ASIR decreased in females [EAPC=-0.88, 95%CI (-1.35, -0.40)] but remained essentially stable in males [EAPC=0.09, 95%CI (-0.24, 0.41)]. Similarly, the ASPR declined in females [EAPC=-0.72, 95%CI (-1.03, -0.41)] and showed a slight, non-significant increase among males [EAPC=0.18, 95%CI (-0.03, 0.40)]. Provincial trend analyses showed increasing ASPR of RI-TBI in Jiangsu and Shanxi provinces. By road-user category, the disease burden of pedestrian-related RI-TBI was the greatest.

Conclusion From 1990 to 2021, the absolute burden of RI-TBI in China increased, whereas age-standardized rates were generally stable or declined. The burden of RI-TBI in China varies markedly across provinces and by injury type. Targeted interventions and prevention strategies that account for demographic and geographic heterogeneity should be developed and implemented to reduce incidence and overall disease burden.

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