Global burden of fall-related fractures in children aged <14 years

Background: Falls represent a common cause of pediatric fractures, and this study reports on the global disease burden of fall-related fractures in children. Methods: Epidemiological data on subtypes of fall-related fractures in children were sourced from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, encompassing annual estimates from 1990 to 2021. We analyzed the disease burden and epidemiological trends of distinct fracture subtypes attributable to falls. The Concentration Index and Slope Index were employed to measure health inequity disparities associated with the global burden of fall-related pediatric fractures between 1990 and 2021. For both indices, countries were ranked by Socio-demographic Index (SDI) quintiles, and all estimates were population-weighted. The Slope Index was derived by reorganizing data according to the WHO Handbook on Health Inequality Monitoring and computed using robust regression (rlm) in R (version 4.3.1). The Concentration Index was calculated by invoking Stata’s conindex command (version 1.1.0) from the inequal package (Stata/MP 18.0). Using the Bayesian Age-Period-Cohort (BAPC) model, we projected the global burden of fall-related pediatric fractures through 2050. Result: In 2021, the global ASIR for fall-related pediatric fractures was 762.11 (540.88–1004.70) per 100 000 person-years, with a total of 15 332 522 (10 881 681–20 213 253) cases. From 1990 to 2021, the global AAPC for fall-related pediatric fractures was −0.88 (−0.91 to −0.85). The Slope Index for this injury significantly declined from 1338 (95% CI: 1052–1624) to 1221 (95% CI: 974–1467). Concurrently, the relative inequality remained essentially unchanged (Concentration Index ≈ 0.21). Based on the BAPC model, by 2050, the ASIR of fall-related pediatric fractures globally is projected to be 842.55 per 100 000 person-years, and the number of cases is estimated to be 15 616 870. Conclusion Despite some improvements, fall-related pediatric fractures continue to pose a substantial disease burden.