Pressure Injury Incidence and Quality of Care Index (1990-2021): An Analysis of Trends and Health Inequalities Based on the Study of Global Burden of Disease 2021.

Objectives: To elucidate the global disease burden and care quality associated with pressure injury (PI). Approach: This study examined temporal trends in PI incidence over the past 32 years. Decomposition analysis attributed these trends to demographic and epidemiological shifts, and cross-national health inequities were quantified. The Quality of Care Index (QCI) was constructed using principal component analysis to assess spatiotemporal variations in global PI care quality. A log-linear age-period-cohort model was employed to forecast trends over the next 15 years. Results: In 2021, there were nearly 2.47 million PI cases globally, a 115.92% increase from 1.14 million in 1990. Decomposition analysis revealed that population aging and demographic growth were the primary drivers of increasing PI incidence. Lower QCI was concentrated in African countries and those with low sociodemographic index (SDI). Incidence rates increased gradually with improving SDI. Significant health inequalities existed among 204 countries and regions, with minimal changes in inequality slope indices over time. Projections indicate a gradual increase to 3.5 million PI cases globally by 2035. Innovation: This study developed a novel comprehensive indicator, the QCI, and for the first time, shed light on health inequalities in PI across 204 countries and territories. Conclusion: Over the past 32 years, the global disease burden of PI has been significant, accompanied by health inequalities across countries and regions. For nations with low SDI, there remains considerable room for improvement in the quality of care for PI, necessitating more effective strategies to address health care disparities.