Increasing pressure ulcer burden in China: Age and gender differences based on GBD data

HUANG Zhenjia; WU Li; TANG Yong; LI Dan; LAN Xiaodong

doi:10.16016/j.2097-0927.202509020

您当前的位置：

首页 >

文章列表页 >

Increasing pressure ulcer burden in China: Age and gender differences based on GBD data

Think Tank for Public Health | 更新时间：2025-12-25

- Increasing pressure ulcer burden in China: Age and gender differences based on GBD data
- Journal of Army Medical University Vol. 47, Issue 20, Pages: 2548-2557(2025)
- 作者机构：
  
  四川大学华西临床医学院，四川大学附属成都市第二人民医院烧伤整形科，四川成都
- 作者简介：
- 基金信息：
  
  the Research Project of Chengdu Science and Technology Bureau(2019-YF05-00010-SN)
- DOI：10.16016/j.2097-0927.202509020
  CLC： R195.4;R632.1
- Received：04 September 2025，
  
  Revised：2025-10-11，
  
  Accepted：11 October 2025，
  
  Published：30 October 2025
- 稿件说明：
移动端阅览
黄震佳，吴丽，汤勇，等.中国日益加重的压疮公共卫生负担：基于GBD数据的年龄与性别差异分析［J］.陆军军医大学学报，2025，47（20）：2548-2557.DOI：10.16016/j.2097-0927.202509020.

HUANG Z J，WU L，TANG Y，et al.Increasing pressure ulcer burden in China： Age and gender differences based on GBD data［J］.J Army Med Univ，2025，47（20）：2548-2557.DOI：10.16016/j.2097-0927.202509020.
黄震佳，吴丽，汤勇，等.中国日益加重的压疮公共卫生负担：基于GBD数据的年龄与性别差异分析［J］.陆军军医大学学报，2025，47（20）：2548-2557.DOI：10.16016/j.2097-0927.202509020. DOI：

HUANG Z J，WU L，TANG Y，et al.Increasing pressure ulcer burden in China： Age and gender differences based on GBD data［J］.J Army Med Univ，2025，47（20）：2548-2557.DOI：10.16016/j.2097-0927.202509020. DOI：

摘要

目的

基于1990—2021年全球疾病负担（global burden of disease，GBD）数据，分析中国一般人群（所有年龄组）及≥65岁老年人群压疮负担及其变化趋势，并预测2022—2035年的负担趋势，解决压疮防控中长期趋势不明及精准干预不足的公共卫生问题，为制定针对性防控策略提供依据。

方法

从GBD数据库提取中国1990—2021年一般人群及≥65岁老年人群压疮的发病数、死亡数及伤残调整生命年数（disability-adjusted life years，DALYs）；同时提取一般人群的年龄标准化发病率（age-standardized incidence rate，ASIR）、死亡率（age-standardized mortality rate，ASMR）及伤残调整生命年率（age-standardized disability-adjusted life year rate，ASDR），并基于GBD 2021标准人口估算≥65岁老年人群对应的年龄标准化率（age-standardized rates，ASRs）。计算ASRs的年均变化百分比（estimated annual percentage changes，EAPCs）以评估趋势。采用贝叶斯年龄-时期-队列（bayesian age-period-cohort，BAPC）模型，分别预测一般人群和老年人群2022—2035年的ASRs及变化趋势。

结果

1990—2021年，中国一般人群压疮发病数由163 508.67例（95%

：142 891.48~184 055.10）增至397 312.27例（95%

：360 058.44~444 875.78），死亡数由242.51例（95%

：125.26~702.84）激增至3 131.54例（95%

：1 562.60~4 126.85），DALYs由11 965.10人年（95%

：7 820.54~21 703.78）增至61 933.91人年（95%

：36 313.26~77 402.42）。同期，ASIR、ASMR及ASDR的EAPC分别为1.06（95%

：0.84~1.28）、3.63（95%

：3.45~3.81）和2.76（95%

：2.60~2.92），均显著上升。2021年，男性发病数及DALYs均高于女性，死亡数相近；男性ASIR、ASMR及ASDR均高于女性，且两性增长均较快。各指标随年龄显著增加，预测至2035年，中国一般人群ASIR、ASMR和ASDR将继续显著上升。1990—2021年，中国老年人群（≥65岁）压疮发病数由42 334.95例（95%

：35 739.05~48 930.84）增至238 431.65例（95%

：212 539.53~264 323.77），死亡数由204.97例（95%

：93.33~316.60）增至2 871.02例（95%

：2 334.39~3 407.66），DALYs由4 619.74人年（95%

：2 990.73~6 248.76）增至43 968.28人年（95%

：37 542.85~50 393.70）。ASIR、ASMR和ASDR的EAPC分别为2.62（95%

：2.44~2.80）、3.54（95%

：3.38~3.70）和3.28（95%

：3.14~3.42），均显著上升。2021年，老年男性与女性的发病数、死亡数及DALYs相近，但男性ASIR、ASMR及ASDR均高于女性，且增长更快。预计到2035年，老年人群的ASIR显著下降至146.24（95%

：140.35~152.14），EAPC为-0.57（95%

：-0.64~-0.50），但ASMR和ASDR将继续上升，且男性高于女性。

结论

1990-2021年，中国一般人群及老年人群压疮发病数、死亡数及DALYs显著增加，且ASRs快速上升。压疮负担随年龄增长显著增加，男性高于女性。预测显示，一般人群ASIR将持续上升，老年人ASIR略降，但ASMR、ASDR将继续升高。

对策

持续加强压疮防控，针对老年人，尤其是老年男性实施精准干预，推广标准化护理指南，提升基层医疗培训和资源投入，建立全国压疮监测系统。

Abstract

Objective

To analyze the burden of pressure ulcers and its changing trends among the general population (all age groups) and the elderly aged 65 years and above in China based on the global burden of disease (GBD) data from 1990 to 2021

predict the burden trends from 2022 to 2035

and address the public health issues of its unclear medium- and long-term trends and insufficient precise interventions in its prevention and control in order to provide support for formulating targeted prevention and control strategies.

Methods

The GBD database was used to extract the incidence

mortality and disability-adjusted life years (DALYs) of pressure ulcers in the general population and in the elderly aged 65 years and above in China from 1990 to 2021. Meanwhile

the age-standardized incidence rate (ASIR)

mortality rate (ASMR)

and disability-adjusted life rate (ASDR) of the general population were also extracted

and the age-standardized rate (ASRs) corresponding to the elderly population aged 65 years and above were estimated based on the GBD 2021 standard population. The average annual percentage changes (EAPCs) of ASRs were calculated to assess the trends. Bayesian age-period-cohort (BAPC) model was adopted to predict the ASRs and their changing trends of the general and elderly population from 2022 to 2035

respectively.

Results

From 1990 to 2021

the number of pressure ulcer cases in the general population of China increased from 163 508.67 (95%

: 142 891.48~184 055.10) cases to 397 312.27 (95%

: 360 058.44~444 875.78) cases

the number of deaths soared from 242.51 (95%

: 125.26~702.84) cases to 3 131.54 (95%

: 1 562.60~4 126.85) cases

and DALYs increased from 11 965.10 (95%

: 7 820.54~21 703.78) to 61 933.91 (95%

: 36 313.26~77 402.42). During the same period

the EAPCs of ASIR

ASMR and ASDR were 1.06 (95%

: 0.84~1.28)

3.63 (95%

: 3.45~3.81)

and 2.76 (95%

: 2.60~2.92)

respectively. In 2021

the number of male cases and DALYs were both higher than those of females

while the number of deaths was similar. The ASIR

ASMR and ASDR of the males were all higher than those of the females

and the growth rates of both genders were relatively fast. All indicators were increased significantly with age. It is predicted that by 2035

the ASIR

ASMR

and ASDR in the general Chinese population will continue to rise significantly. From 1990 to 2021

the number of pressure ulcer cases among the elderly (≥65 years old) in China increased from 42 334.95 (95%

: 35 739.05~48 930.84) to 238 431.65 (95%

: 212 539.53~264 323.77). The number of deaths rose from 204.97 (95%

: 93.33~316.60) to 2 871.02 (95%

: 2 334.39~3 407.66)

and DALYs increased from 4 619.74 (95%

: 2 990.73~6 248.76) to 43 968.28 (95%

: 37 542.85

50 393.70). The EAPCs of ASIR

ASMR

and ASDR were 2.62 (95%

: 2.44~2.80)

3.54 (95%

: 3.38

~3.70)

and 3.28 (95%

: 3.14~3.42)

all of which increased significantly. In 2021

the number of cases

deaths and DALYs among elderly men and women were similar

but the ASIR

ASMR and ASDR of men were all higher than those of women

and their growth rates were faster. It is projected that by 2035

the ASIR of the elderly population will significantly decline to 146.24(95%

: 140.35~152.14)

with an EAPC of -0.57 (95%

: -0.64~-0.50)

while the ASMR and ASDR will continue to rise and remain higher in males than in females.

Conclusion

From 1990 to 2021

the number of pressure ulcer cases

deaths and DALYs among the general population and the elderly in China increased significantly

and the ASRs rose rapidly. The burden of pressure ulcers increases significantly with age and is higher in men than in women. Predictions show that ASIR in the general population will continue to rise

while that in the elderly will slightly decline. However

the ASMR and ASDR will continue to increase. Countermeasures　Continuously strengthen the prevention and control of pressure ulcers

implement precise intervention for the elderly

especially older men

promote standardized nursing guidelines

enhance training and resource input in primary medical care

and establish a national pressure ulcer monitoring system.

关键词

Keywords

references

MERVIS J S ， PHILLIPS T J . Pressure ulcers： Pathophysiology， epidemiology， risk factors， and presentation ［J］. J Am Acad Dermatol ， 2019 ， 81 （ 4 ）： 881 - 890 . DOI： 10.1016/j.jaad. 2018.12.069 http://dx.doi.org/10.1016/j.jaad.2018.12.069 .

HAJHOSSEINI B ， LONGAKER M T ， GURTNER G C . Pressure injury ［J］. Ann Surg ， 2020 ， 271 （ 4 ）： 671 - 679 . DOI： 10.1097/sla.0000000000003567 http://dx.doi.org/10.1097/sla.0000000000003567 .

KOTTNER J ， CUDDIGAN J ， CARVILLE K ， et al . Pressure ulcer/injury classification today： an international perspective ［J］. J Tissue Viability ， 2020 ， 29 （ 3 ）： 197 - 203 . DOI： 10.1016/j.jtv.2020.04.003 http://dx.doi.org/10.1016/j.jtv.2020.04.003 .

CHUNG M L ， WIDDEL M ， KIRCHHOFF J ， et al . Risk factors for pressure injuries in adult patients： a narrative synthesis ［J］. Int J Environ Res Public Health ， 2022 ， 19 （ 2 ）： 761 . DOI： 10.3390/ijerph19020761 http://dx.doi.org/10.3390/ijerph19020761 .

DEMARRÉ L ， VAN LANCKER A ， VAN HECKE A ， et al . The cost of prevention and treatment of pressure ulcers： a systematic review ［J］. Int J Nurs Stud ， 2015 ， 52 （ 11 ）： 1754 - 1774 . DOI： 10.1016/j.ijnurstu.2015.06.006 http://dx.doi.org/10.1016/j.ijnurstu.2015.06.006 .

GORECKI C ， BROWN J M ， NELSON E A ， et al . Impact of pressure ulcers on quality of life in older patients： a systematic review ［J］. J Am Geriatr Soc ， 2009 ， 57 （ 7 ）： 1175 - 1183 . DOI： 10.1111/j.1532-5415.2009.02307.x http://dx.doi.org/10.1111/j.1532-5415.2009.02307.x .

BHATTACHARYA S ， MISHRA R K . Pressure ulcers： Current understanding and newer modalities of treatment ［J］. Indian J Plast Surg ， 2015 ， 48 （ 1 ）： 4 - 16 . DOI： 10.4103/0970-0358.155260 http://dx.doi.org/10.4103/0970-0358.155260 .

ARMOUR D J ， PRESTON-HSU E ， TAILOR Y . Management of pressure ulcers and pressure-related injury ［J］. Curr Phys Med Rehabil Rep ， 2019 ， 7 （ 2 ）： 170 - 177 . DOI： 10.1007/s40141-019-00222-x http://dx.doi.org/10.1007/s40141-019-00222-x .

ZHANG S Y ， WEI G X ， HAN L ， et al . Global， regional and national burden of decubitus ulcers in 204 countries and territories from 1990 to 2021： a systematic analysis based on the global burden of disease study 2021 ［J］. Front Public Health ， 2025 ， 13 ： 1494229 . DOI： 10.3389/fpubh. 2025.1494229 http://dx.doi.org/10.3389/fpubh.2025.1494229 .

LAN X D ， TANG Y ， HUANG Z J ， et al . Global， regional， and national burden of pressure ulcers from 1990 to 2021 and projections over the next decade： results from the 2021 GBD study ［J］. Wound Repair Regen ， 2025 ， 33 （ 4 ）： e70064 . DOI： 10.1111/wrr.70064 http://dx.doi.org/10.1111/wrr.70064 .

LI R J ， YANG X N ， CHEN H B ， et al . Global， regional， and national trends in decubitus ulcer burden from 1990 to 2021 and forecasts to 2040 ［J］. Front Public Health ， 2025 ， 13 ： 1603321 . DOI： 10.3389/fpubh.2025.1603321 http://dx.doi.org/10.3389/fpubh.2025.1603321 .

PANG Y S ， DU Y B ， ZHOU W ， et al . Trend analysis of pressure ulcers in adults 60 years and older from 1990 to 2021 using jointpoint regression and Bayesian age period cohort models ［J］. Sci Rep ， 2025 ， 15 （ 1 ）： 25198 . DOI： 10.1038/s41598-025-11027-5 http://dx.doi.org/10.1038/s41598-025-11027-5 .

COWAN L ， BRODERICK V ， ALDERDEN J G . Pressure injury prevention considerations for older adults ［J］. Crit Care Nurs Clin North Am ， 2020 ， 32 （ 4 ）： 601 - 609 . DOI： 10.1016/j.cnc.2020.08.009 http://dx.doi.org/10.1016/j.cnc.2020.08.009 .

WU W Q ， LONG S J ， CERDA A A ， et al . Population ageing and sustainability of healthcare financing in China ［J］. Cost Eff Resour Alloc ， 2023 ， 21 （ 1 ）： 97 . DOI： 10.1186/s12962-023-00505-0 http://dx.doi.org/10.1186/s12962-023-00505-0 .

Global Burden of Disease 2021 Healthcare Access and Quality Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations， 1990—2021： a systematic analysis for the Global Burden of Disease Study 2021 ［J］. Lancet ， 2024 ， 403 （ 10440 ）： 2100 - 2132 . DOI： 10.1016/S0140-6736（24）00367-2 http://dx.doi.org/10.1016/S0140-6736（24）00367-2 .

QIN Y H ， TONG X ， FAN J H ， et al . Global burden and trends in incidence， mortality， and disability of stomach cancer from 1990 to 2017 ［J］. Clin Transl Gastroenterol ， 2021 ， 12 （ 10 ）： e00406 . DOI： 10.14309/ctg.0000000000000406 http://dx.doi.org/10.14309/ctg.0000000000000406 .

RIEBLER A ， HELD L . Projecting the future burden of cancer： Bayesian age-period-cohort analysis with integrated nested Laplace approximations ［J］. Biom J ， 2017 ， 59 （ 3 ）： 531 - 549 . DOI： 10.1002/bimj.201500263 http://dx.doi.org/10.1002/bimj.201500263 .

乔晓春 . 中国人口老龄化的过去、现在和未来［J］. 社会政策研究， 2024 （ 1 ）： 47 - 63， 133 . DOI： 10.19506/j.cnki.cn10-1428/d.2024.01.001 http://dx.doi.org/10.19506/j.cnki.cn10-1428/d.2024.01.001 .

QIAO X C . Ageing in China： past， present， and future ［J］. Soc Policy Res ， 2024 （ 1 ）： 47 - 63， 133 . DOI： 10.19506/j.cnki.cn10-1428/d.2024.01.001 http://dx.doi.org/10.19506/j.cnki.cn10-1428/d.2024.01.001 .

GOULD L J ， ALDERDEN J ， ASLAM R ， et al . WHS guidelines for the treatment of pressure ulcers-2023 update ［J］. Wound Repair Regen ， 2024 ， 32 （ 1 ）： 6 - 33 . DOI： 10.1111/wrr.13130 http://dx.doi.org/10.1111/wrr.13130 .

杜鹏，纪竞垚 . 中国长期照护政策体系建设的进展、挑战与发展方向［J］. 中国卫生政策研究， 2019 ， 12 （ 1 ）： 29 - 34 . DOI： 10.3969/j.issn.1674-2982.2019.01.004 http://dx.doi.org/10.3969/j.issn.1674-2982.2019.01.004 .

DU P ， JI J Y . Progress， challenges and prospects of long-term care policy in China ［J］. Chin J Health Policy ， 2019 ， 12 （ 1 ）： 29 - 34 . DOI： 10.3969/j.issn.1674-2982.2019.01.004 http://dx.doi.org/10.3969/j.issn.1674-2982.2019.01.004 .

LICHTERFELD-KOTTNER A ， LAHMANN N ， KOTTNER J . Sex-specific differences in prevention and treatment of institutional-acquired pressure ulcers in hospitals and nursing homes ［J］. J Tissue Viability ， 2020 ， 29 （ 3 ）： 204 - 210 . DOI： 10.1016/j.jtv.2020.05.001 http://dx.doi.org/10.1016/j.jtv.2020.05.001 .

王丽敏，陈志华，张梅，等 . 中国老年人群慢性病患病状况和疾病负担研究［J］. 中华流行病学杂志， 2019 ， 40 （ 3 ）： 277 - 283 . DOI： 10.3760/cma.j.issn.0254-6450.2019.03.005 http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2019.03.005 .

WANG L M ， CHEN Z H ， ZHANG M ， et al . Study on the prevalence and burden of chronic diseases among the elderly in China ［J］. Chin J Epidemiol ， 2019 ， 40 （ 3 ）： 277 - 283 . DOI： 10.3760/cma.j.issn.0254-6450.2019.03.005 http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2019.03.005 .

WU B B ， GU D Z ， YU J N ， et al . Relationship between smoking and pressure injury risk： a systematic review and meta-analysis ［J］. Wound Manag Prev ， 2021 ， 67 （ 9 ）： 34 - 46 .

FENG Z L ， LIU C ， GUAN X P ， et al . China’s rapidly aging population creates policy challenges in shaping a viable long-term care system ［J］. Health Aff ， 2012 ， 31 （ 12 ）： 2764 - 2773 . DOI： 10.1377/hlthaff.2012.0535 http://dx.doi.org/10.1377/hlthaff.2012.0535 .

WANG Q W ， MA Y ， CHEN J Y ， et al . Modernizing care for older adults： long-term care policy evolution and challenges in China ［J］. J Aging Soc Policy ， 2025 ： 1 - 17 . DOI： 10.1080/08959420.2025.2482299 http://dx.doi.org/10.1080/08959420.2025.2482299 .

SEIDLER Z E ， BENAKOVIC R ， WILSON M J ， et al . Approaches to engaging men during primary healthcare encounters： a scoping review ［J］. Am J Mens Health ， 2024 ， 18 （ 2 ）： 15579883241241090 . DOI： 10.1177/1557988324 1241090 http://dx.doi.org/10.1177/15579883241241090 .

COURTENAY W H . Constructions of masculinity and their influence on men’s well-being： a theory of gender and health ［J］. Soc Sci Med ， 2000 ， 50 （ 10 ）： 1385 - 1401 . DOI： 10.1016/s0277-9536（99）00390-1 http://dx.doi.org/10.1016/s0277-9536（99）00390-1 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Growing burden of atherosclerotic cardiovascular disease in China: An analysis on lifestyle and metabolic factors based on the Global Burden of Disease Study 2021

Epidemiological characteristics of tuberculosis in a hospital in Lhasa during 2008 and 2020

Establishment and validation of a risk prediction model for postoperative delirium in elderly patients after individualized hip fracture surgery

Influencing factors of quality of bowel preparation for colonoscopy in elderly patients

Related Author

LIANG Jingrong

LIU Jianhua

LIN Derong

HE Ziyi

PENG Xinyu

TU Qiuyue

LUO Yongjun

LIU Yang

Related Institution

Dongguan Hospital， Guangzhou University of Chinese Medicine

Pingshan Hospital of Traditional Chinese Medicine

Guangzhou University of Chinese Medicine

Information Section, 5Department of Health Service, General Hospital of Tibet Military Region, Lhasa, Tibet Autonomous Region

Department of Military Medical Geography, Army Medical Service Training Base, 3Department of Military Epidemiology, Faculty of Military Preventive Medicine, Army Medical University (Third Military Medical University)

⁰