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Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

James, Spencer L; Theadom, Alice; Ellenbogen, Richard G; Bannick, Marlena S; Montjoy-Venning, Wcliff; Lucchesi, Lydia R; Abbasi, Nooshin; Abdulkader, Rizwan; Abraha, Haftom Niguse; Adsuar, Jose C; Afarideh, Mohsen; Agrawal, Sutapa; Ahmadi, Alireza; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Akinyemi, Rufus Olusola; Akseer, Nadia; Alahdab, Fares; Alebel, Animut; Alghnam, Suliman A; Ali, Beriwan Abdulqadir; Alsharif, Ubai; Altirkawi, Khalid; Andrei, Catalina Liliana; Anjomshoa, Mina; Ansari, Hossein; Ansha, Mustafa Geleto; Antonio, Carl Abelardo T; Appiah, Seth Christopher Yaw; Ariani, Filippo; Asefa, Nigus Gebremedhin; Asgedom, Solomon Weldegebreal; Atique, Suleman; Awasthi, Ashish; Ayala Quintanilla, Beatriz Paulina; Ayuk, Tambe B; Azzopardi, Peter S; Badali, Hamid; Badawi, Alaa; Balalla, Shivanthi; Banstola, Amrit; Barker-Collo, Suzanne Lyn; Bärnighausen, Till Winfried; Bedi, Neeraj; Behzadifar, Masoud; Behzadifar, Meysam; Bekele, Bayu Begashaw; Belachew, Abate Bekele; Belay, Yihalem Abebe; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Beuran, Mircea; Bhalla, Ashish; Bhaumik, Soumyadeeep; Bhutta, Zulfiqar A; Biadgo, Belete; Biffino, Marco; Bijani, Ali; Bililign, Nigus; Birungi, Charles; Boufous, Soufiane; Brazinova, Alexandra; Brown, Allen W; Car, Mate; Cárdenas, Rosario; Carrero, Juan J; Carvalho, Félix; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Chaiah, Yazan; Champs, Ana Paula; Chang, Jung-Chen; Choi, Jee-Young J; Christopher, Devasahayam J; Cooper, Cyrus; Crowe, Christopher Stephen; Dandona, Lalit; Dandona, Rakhi; Daryani, Ahmad; Davitoiu, Dragos Virgil; Degefa, Meaza Girma; Demoz, Gebre Teklemariam; Deribe, Kebede; Djalalinia, Shirin; Do, Huyen Phuc; Doku, David Teye; Drake, Thomas M; Dubey, Manisha; Dubljanin, Eleonora; El-Khatib, Ziad; Ofori-Asenso, Richard; Eskandarieh, Sharareh; Esteghamati, Alireza; Esteghamati, Sadaf; Faro, Andre; Farzadfar, Farshad; Farzaei, Mohammad Hosein; Fereshtehnejad, Seyed-Mohammad; Fernandes, Eduarda; Feyissa, Garumma Tolu; Filip, Irina; Fischer, Florian; Fukumoto, Takeshi; Ganji, Morasaleh; Gankpe, Fortune Gbetoho; Gebre, Abadi Kahsu; Gebrehiwot, Tsegaye Tewelde; Gezae, Kebede Embaye; Gopalkrishna, Gururaj; Goulart, Alessandra C; Haagsma, Juanita A; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hamadeh, Randah R; Hamidi, Samer; Haro, Josep Maria; Hassankhani, Hadi; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hawley, Caitlin; Hay, Simon I; Hegazy, Mohamed I; Hendrie, Delia; Henok, Andualem; Hibstu, Desalegn Tsegaw; Hoffman, Howard J; Hole, Michael K; Homaie Rad, Enayatollah; Hosseini, Seyed Mostafa; Hostiuc, Sorin; Hu, Guoqing; Hussen, Mamusha Aman; Ilesanmi, Olayinka Stephen; Irvani, Seyed Sina Naghibi; Jakovljevic, Mihajlo; Jayaraman, Sudha; Jha, Ravi Prakash; Jonas, Jost B; Jones, Kelly M; Jorjoran Shushtari, Zahra; Jozwiak, Jacek Jerzy; Jürisson, Mikk; Kabir, Ali; Kahsay, Amaha; Kahssay, Molla; Kalani, Rizwan; Karch, André; Kasaeian, Amir; Kassa, Getachew Mullu; Kassa, Tesfaye Dessale; Kassa, Zemenu Yohannes; Kengne, Andre Pascal; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khalid, Nauman; Khalil, Ibrahim; Khan, Ejaz Ahmad; Khan, Muhammad Shahzeb; Khang, Young-Ho; Khazaie, Habibolah; Khoja, Abdullah T; Khubchandani, Jagdish; Kiadaliri, Aliasghar A; Kim, Daniel; Kim, Young-Eun; Kisa, Adnan; Koyanagi, Ai; Krohn, Kristopher J; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kumar, G Anil; Kumar, Manasi; Lalloo, Ratilal; Lami, Faris Hasan; Lansingh, Van C; Laryea, Dennis Odai; Latifi, Arman; Leshargie, Cheru Tesema; Levi, Miriam; Li, Shanshan; Liben, Misgan Legesse; Lotufo, Paulo A; Lunevicius, Raimundas; Mahotra, Narayan Bahadur; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Manda, Ana-Laura; Mansournia, Mohammad Ali; Massenburg, Benjamin Ballard; Mate, Kedar K V; Mehndiratta, Man Mohan; Mehta, Varshil; Meles, Hagazi; Melese, Addisu; Memiah, Peter T N; Mendoza, Walter; Mengistu, Getnet; Meretoja, Atte; Meretoja, Tuomo J; Mestrovic, Tomislav; Miazgowski, Tomasz; Miller, Ted R; Mini, GK; Mirica, Andreea; Mirrakhimov, Erkin M; Moazen, Babak; Mohammadi, Moslem; Molokhia, Mariam; Monasta, Lorenzo; Mondello, Stefania; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi, Mahmoudreza; Moradi-Lakeh, Maziar; Moradinazar, Mehdi; Morrison, Shane Douglas; Moschos, Marilita M; Mousavi, Seyyed Meysam; Murthy, Srinivas; Musa, Kamarul Imran; Mustafa, Ghulam; Naghavi, Mohsen; Naik, Gurudatta; Najafi, Farid; Nangia, Vinay; Nascimento, Bruno Ramos; Negoi, Ionut; Nguyen, Trang Huyen; Nichols, Emma; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Nyasulu, Peter S; Ogbo, Felix Akpojene; Oh, In-Hwan; Okoro, Anselm; Olagunju, Andrew T; Olagunju, Tinuke O; Olivares, Pedro R; Otstavnov, Stanislav S; Owolabi, Mayowa Ojo; P A, Mahesh; Pakhale, Smita; Pandey, Achyut Raj; Pesudovs, Konrad; Pinilla-Monsalve, Gabriel D; Polinder, Suzanne; Poustchi, Hossein; Prakash, Swayam; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rafiei, Alireza; Rahimi-Movaghar, Afarin; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Muhammad Aziz; Rai, Rajesh Kumar; Rajati, Fatemeh; Ram, Usha; Rawaf, David Laith; Rawaf, Salman; Reiner, Robert C; Reis, Cesar; Renzaho, Andre M N; Resnikoff, Serge; Rezaei, Satar; Rezaeian, Shahab; Roever, Leonardo; Ronfani, Luca; Roshandel, Gholamreza; Roy, Nobhojit; Ruhago, George Mugambage; Saddik, Basema; Safari, Hosein; Safiri, Saeid; Sahraian, Mohammad Ali; Salamati, Payman; Saldanha, Raphael de Freitas; Samy, Abdallah M; Sanabria, Juan; Santos, João Vasco; Santric Milicevic, Milena M M; Sartorius, Benn; Satpathy, Maheswar; Savuon, Kim; Schneider, Ione J C; Schwebel, David C; Sepanlou, Sadaf G; Shabaninejad, Hosein; Shaikh, Masood A Ali; Shams-Beyranvand, Mehran; Sharif, Mehdi; Sharif-Alhoseini, Mahdi; Shariful Islam, Sheikh Mohammed; She, Jun; Sheikh, Aziz; Shen, Jiabin; Sheth, Kevin N; Shibuya, Kenji; Shiferaw, Mekonnen Sisay; Shigematsu, Mika; Shiri, Rahman; Shiue, Ivy; Shoman, Haitham; Siabani, Soraya; Siddiqi, Tariq J; Silva, João Pedro; Silveira, Dayane Gabriele Alves; Sinha, Dhirendra Narain; Smith, Mari; Soares Filho, Adauto Martins; Sobhani, Soheila; Soofi, Moslem; Soriano, Joan B; Soyiri, Ireneous N; Stein, Dan J; Stokes, Mark A; Sufiyan, Mu'awiyyah Babale; Sunguya, Bruno F; Sunshine, Jacob E; Sykes, Bryan L; Szoeke, Cassandra E I; Tabarés-Seisdedos, Rafael; Te Ao, Braden James; Tehrani-Banihashemi, Arash; Tekle, Merhawi Gebremedhin; Temsah, Mohamad-Hani; Temsah, Omar; Topor-Madry, Roman; Tortajada-Girbés, Miguel - -; Tran, Bach Xuan; Tran, Khanh Bao; Tudor Car, Lorainne; Ukwaja, Kingsley Nnanna; Ullah, Irfan; Usman, Muhammad Shariq; Uthman, Olalekan A; Valdez, Pascual R; Vasankari, Tommi Juhani; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Wagnew, Fasil Wagnew Shiferaw; Waheed, Yasir; Wang, Yuan-Pang; Weldegwergs, Kidu Gidey; Werdecker, Andrea; Wijeratne, Tissa; Winkler, Andrea Sylvia; Wyper, Grant M A; Yano, Yuichiro; Yaseri, Mehdi; Yasin, Yasin Jemal; Ye, Pengpeng; Yimer, Ebrahim M; Yip, Paul; Yisma, Engida; Yonemoto, Naohiro; Yoon, Seok-Jun; Yost, Michael G; Younis, Mustafa Z; Yousefifard, Mahmoud; Yu, Chuanhua; Zaidi, Zoubida; Zaman, Sojib Bin; Zamani, Mohammad; Zenebe, Zerihun Menlkalew; Zodpey, Sanjay; Feigin, Valery L; Vos, Theo; Murray, Christopher J L

Authors

Spencer L James

Alice Theadom

Richard G Ellenbogen

Marlena S Bannick

Wcliff Montjoy-Venning

Lydia R Lucchesi

Nooshin Abbasi

Rizwan Abdulkader

Haftom Niguse Abraha

Jose C Adsuar

Mohsen Afarideh

Sutapa Agrawal

Alireza Ahmadi

Muktar Beshir Ahmed

Amani Nidhal Aichour

Ibtihel Aichour

Miloud Taki Eddine Aichour

Rufus Olusola Akinyemi

Nadia Akseer

Fares Alahdab

Animut Alebel

Suliman A Alghnam

Beriwan Abdulqadir Ali

Ubai Alsharif

Khalid Altirkawi

Catalina Liliana Andrei

Mina Anjomshoa

Hossein Ansari

Mustafa Geleto Ansha

Carl Abelardo T Antonio

Seth Christopher Yaw Appiah

Filippo Ariani

Nigus Gebremedhin Asefa

Solomon Weldegebreal Asgedom

Suleman Atique

Ashish Awasthi

Beatriz Paulina Ayala Quintanilla

Tambe B Ayuk

Peter S Azzopardi

Hamid Badali

Alaa Badawi

Shivanthi Balalla

Amrit Banstola

Suzanne Lyn Barker-Collo

Till Winfried Bärnighausen

Neeraj Bedi

Masoud Behzadifar

Meysam Behzadifar

Bayu Begashaw Bekele

Abate Bekele Belachew

Yihalem Abebe Belay

Derrick A Bennett

Isabela M Bensenor

Adugnaw Berhane

Mircea Beuran

Ashish Bhalla

Soumyadeeep Bhaumik

Zulfiqar A Bhutta

Belete Biadgo

Marco Biffino

Ali Bijani

Nigus Bililign

Charles Birungi

Soufiane Boufous

Alexandra Brazinova

Allen W Brown

Mate Car

Rosario Cárdenas

Juan J Carrero

Félix Carvalho

Carlos A Castañeda-Orjuela

Ferrán Catalá-López

Yazan Chaiah

Ana Paula Champs

Jung-Chen Chang

Jee-Young J Choi

Devasahayam J Christopher

Cyrus Cooper

Christopher Stephen Crowe

Lalit Dandona

Rakhi Dandona

Ahmad Daryani

Dragos Virgil Davitoiu

Meaza Girma Degefa

Gebre Teklemariam Demoz

Kebede Deribe

Shirin Djalalinia

Huyen Phuc Do

David Teye Doku

Thomas M Drake

Manisha Dubey

Eleonora Dubljanin

Ziad El-Khatib

Richard Ofori-Asenso

Sharareh Eskandarieh

Alireza Esteghamati

Sadaf Esteghamati

Andre Faro

Farshad Farzadfar

Mohammad Hosein Farzaei

Seyed-Mohammad Fereshtehnejad

Eduarda Fernandes

Garumma Tolu Feyissa

Irina Filip

Florian Fischer

Takeshi Fukumoto

Morasaleh Ganji

Fortune Gbetoho Gankpe

Abadi Kahsu Gebre

Tsegaye Tewelde Gebrehiwot

Kebede Embaye Gezae

Gururaj Gopalkrishna

Alessandra C Goulart

Juanita A Haagsma

Arvin Haj-Mirzaian

Arya Haj-Mirzaian

Randah R Hamadeh

Samer Hamidi

Josep Maria Haro

Hadi Hassankhani

Hamid Yimam Hassen

Rasmus Havmoeller

Caitlin Hawley

Simon I Hay

Mohamed I Hegazy

Delia Hendrie

Andualem Henok

Desalegn Tsegaw Hibstu

Howard J Hoffman

Michael K Hole

Enayatollah Homaie Rad

Seyed Mostafa Hosseini

Sorin Hostiuc

Guoqing Hu

Mamusha Aman Hussen

Olayinka Stephen Ilesanmi

Seyed Sina Naghibi Irvani

Mihajlo Jakovljevic

Sudha Jayaraman

Ravi Prakash Jha

Jost B Jonas

Kelly M Jones

Zahra Jorjoran Shushtari

Jacek Jerzy Jozwiak

Mikk Jürisson

Ali Kabir

Amaha Kahsay

Molla Kahssay

Rizwan Kalani

André Karch

Amir Kasaeian

Getachew Mullu Kassa

Tesfaye Dessale Kassa

Zemenu Yohannes Kassa

Andre Pascal Kengne

Yousef Saleh Khader

Morteza Abdullatif Khafaie

Nauman Khalid

Ibrahim Khalil

Ejaz Ahmad Khan

Muhammad Shahzeb Khan

Young-Ho Khang

Habibolah Khazaie

Abdullah T Khoja

Jagdish Khubchandani

Aliasghar A Kiadaliri

Daniel Kim

Young-Eun Kim

Adnan Kisa

Ai Koyanagi

Kristopher J Krohn

Barthelemy Kuate Defo

Burcu Kucuk Bicer

G Anil Kumar

Manasi Kumar

Ratilal Lalloo

Faris Hasan Lami

Van C Lansingh

Dennis Odai Laryea

Arman Latifi

Cheru Tesema Leshargie

Miriam Levi

Shanshan Li

Misgan Legesse Liben

Paulo A Lotufo

Raimundas Lunevicius

Narayan Bahadur Mahotra

Marek Majdan

Azeem Majeed

Reza Malekzadeh

Ana-Laura Manda

Mohammad Ali Mansournia

Benjamin Ballard Massenburg

Kedar K V Mate

Man Mohan Mehndiratta

Varshil Mehta

Hagazi Meles

Addisu Melese

Peter T N Memiah

Walter Mendoza

Getnet Mengistu

Atte Meretoja

Tuomo J Meretoja

Tomislav Mestrovic

Tomasz Miazgowski

Ted R Miller

GK Mini

Andreea Mirica

Erkin M Mirrakhimov

Babak Moazen

Moslem Mohammadi

Mariam Molokhia

Lorenzo Monasta

Stefania Mondello

Mahmood Moosazadeh

Ghobad Moradi

Mahmoudreza Moradi

Maziar Moradi-Lakeh

Mehdi Moradinazar

Shane Douglas Morrison

Marilita M Moschos

Seyyed Meysam Mousavi

Srinivas Murthy

Kamarul Imran Musa

Ghulam Mustafa

Mohsen Naghavi

Gurudatta Naik

Farid Najafi

Vinay Nangia

Bruno Ramos Nascimento

Ionut Negoi

Trang Huyen Nguyen

Emma Nichols

Dina Nur Anggraini Ningrum

Yirga Legesse Nirayo

Peter S Nyasulu

Felix Akpojene Ogbo

In-Hwan Oh

Anselm Okoro

Andrew T Olagunju

Tinuke O Olagunju

Pedro R Olivares

Stanislav S Otstavnov

Mayowa Ojo Owolabi

Mahesh P A

Smita Pakhale

Achyut Raj Pandey

Konrad Pesudovs

Gabriel D Pinilla-Monsalve

Suzanne Polinder

Hossein Poustchi

Swayam Prakash

Mostafa Qorbani

Amir Radfar

Anwar Rafay

Alireza Rafiei

Afarin Rahimi-Movaghar

Vafa Rahimi-Movaghar

Mahfuzar Rahman

Muhammad Aziz Rahman

Rajesh Kumar Rai

Fatemeh Rajati

Usha Ram

David Laith Rawaf

Salman Rawaf

Robert C Reiner

Cesar Reis

Andre M N Renzaho

Serge Resnikoff

Satar Rezaei

Shahab Rezaeian

Leonardo Roever

Luca Ronfani

Gholamreza Roshandel

Nobhojit Roy

George Mugambage Ruhago

Basema Saddik

Hosein Safari

Saeid Safiri

Mohammad Ali Sahraian

Payman Salamati

Raphael de Freitas Saldanha

Abdallah M Samy

Juan Sanabria

João Vasco Santos

Milena M M Santric Milicevic

Benn Sartorius

Maheswar Satpathy

Kim Savuon

Ione J C Schneider

David C Schwebel

Sadaf G Sepanlou

Hosein Shabaninejad

Masood A Ali Shaikh

Mehran Shams-Beyranvand

Mehdi Sharif

Mahdi Sharif-Alhoseini

Sheikh Mohammed Shariful Islam

Jun She

Aziz Sheikh

Jiabin Shen

Kevin N Sheth

Kenji Shibuya

Mekonnen Sisay Shiferaw

Mika Shigematsu

Rahman Shiri

Ivy Shiue

Haitham Shoman

Soraya Siabani

Tariq J Siddiqi

João Pedro Silva

Dayane Gabriele Alves Silveira

Dhirendra Narain Sinha

Mari Smith

Adauto Martins Soares Filho

Soheila Sobhani

Moslem Soofi

Joan B Soriano

Dan J Stein

Mark A Stokes

Mu'awiyyah Babale Sufiyan

Bruno F Sunguya

Jacob E Sunshine

Bryan L Sykes

Cassandra E I Szoeke

Rafael Tabarés-Seisdedos

Braden James Te Ao

Arash Tehrani-Banihashemi

Merhawi Gebremedhin Tekle

Mohamad-Hani Temsah

Omar Temsah

Roman Topor-Madry

Miguel - - Tortajada-Girbés

Bach Xuan Tran

Khanh Bao Tran

Lorainne Tudor Car

Kingsley Nnanna Ukwaja

Irfan Ullah

Muhammad Shariq Usman

Olalekan A Uthman

Pascual R Valdez

Tommi Juhani Vasankari

Narayanaswamy Venketasubramanian

Francesco S Violante

Fasil Wagnew Shiferaw Wagnew

Yasir Waheed

Yuan-Pang Wang

Kidu Gidey Weldegwergs

Andrea Werdecker

Tissa Wijeratne

Andrea Sylvia Winkler

Grant M A Wyper

Yuichiro Yano

Mehdi Yaseri

Yasin Jemal Yasin

Pengpeng Ye

Ebrahim M Yimer

Paul Yip

Engida Yisma

Naohiro Yonemoto

Seok-Jun Yoon

Michael G Yost

Mustafa Z Younis

Mahmoud Yousefifard

Chuanhua Yu

Zoubida Zaidi

Sojib Bin Zaman

Mohammad Zamani

Zerihun Menlkalew Zenebe

Sanjay Zodpey

Valery L Feigin

Theo Vos

Christopher J L Murray



Contributors

Abstract

Background
Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury.

Methods
We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility.

Findings
In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30–30·30 million) new cases of TBI and 0·93 million (0·78–1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331–412) per 100 000 population for TBI and 13 (11–16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40–57·62 million) and of SCI was 27·04 million (24·98–30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (−0·2% [–2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (−3·6% [–7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0–10·4 million) YLDs and SCI caused 9·5 million (6·7–12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82–141) per 100 000 for TBI and 130 (90–170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions.

Interpretation
TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments.

Journal Article Type Article
Publication Date Jan 1, 2019
Journal The Lancet Neurology
Print ISSN 1474-4422
Electronic ISSN 1474-4465
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 18
Issue 1
Pages 56-87
Institution Citation James, S. L., Theadom, A., Ellenbogen, R. G., Bannick, M. S., Montjoy-Venning, W., Lucchesi, L. R., …Murray, C. J. L. (2019). Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurology, 18(1), 56-87. https://doi.org/10.1016/S1474-4422%2818%2930415-0
DOI https://doi.org/10.1016/S1474-4422%2818%2930415-0
Publisher URL https://www.sciencedirect.com/science/article/pii/S1474442218304150

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Copyright Statement
© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.





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