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Background <p>The global burden of disease of paralytic ileus and intestinal obstruction (PIAIO) in young and middle-aged adults (15–49&#xa0;years) has not been systematically assessed. This study is the first to quantitatively analyze the epidemiological characteristics of PIAIO and its association with socioeconomic development level in this population, to reveal its spatiotemporal heterogeneity and health inequality.</p> Methods <p>Data from 204 countries and territories in GBD 2021 were included in this study, and incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were estimated using Bayesian hierarchical modeling with cause of death ensemble modeling. Socioeconomic gradients were assessed by socio-demographic index (SDI) stratification and health inequality analysis. Bayesian age-period-cohort modeling was applied to project disease trends.</p> Results <p>Globally, in 2021, there were 5.61 million new cases of PIAIO, 215,681 prevalent cases, 32,885 deaths, and 1.86 million DALYs lost in people aged 15–49&#xa0;years. During 1990–2021, age-standardized incidence rate (ASIR) and prevalence rate (ASPR) showed a slight upward trend (AAPC 0.06% and 0.05%), but mortality (ASMR) and DALYs rates decreased significantly (AAPC −&#xa0;0.80% and −&#xa0;0.74%). High SDI regions had the highest ASIR (153.28/100,000) and ASPR (5.90/100,000), while Eastern Sub-Saharan Africa had the highest ASMR (3.54/100,000) and DALYs rate (181.53/100,000) globally. At national level, India carries the highest absolute burden, with the highest ASIR of 251.27/100,000 in Japan and the highest ASMR of 6.04/100,000 in Mozambique. Between 1990 and 2021, the ASMR and DALYs rates gradient showed a narrowing of absolute inequality, but relative inequality widened. The absolute number of new cases is projected to increase by 14.2% through 2036, with the ASMR declining by only 0.79 (95% UI: 0.39–1.19) per 100,000 persons-year.</p> Conclusions <p>Young and middle-aged PIAIO showed a global pattern of “high diagnosis in high-income regions and high mortality in low-income regions.” Although advances in surgical techniques have contributed to the decline in mortality, increasing incidence and persistent health inequalities in low SDI regions call for targeted interventions. This study fills the gap in evidence on the burden of disease in this population, and it is necessary to combine data from multiple sources to improve precise prevention and control strategies.</p>

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Global burden of paralytic ileus and intestinal obstruction in young and middle-aged adults (15–49 years): a systematic analysis from global burden of disease study 2021

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  • 发表日期：

    2025年11月17日

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  • Ke Lu,
  • Gang Xu

摘要

Background

The global burden of disease of paralytic ileus and intestinal obstruction (PIAIO) in young and middle-aged adults (15–49 years) has not been systematically assessed. This study is the first to quantitatively analyze the epidemiological characteristics of PIAIO and its association with socioeconomic development level in this population, to reveal its spatiotemporal heterogeneity and health inequality.

Methods

Data from 204 countries and territories in GBD 2021 were included in this study, and incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were estimated using Bayesian hierarchical modeling with cause of death ensemble modeling. Socioeconomic gradients were assessed by socio-demographic index (SDI) stratification and health inequality analysis. Bayesian age-period-cohort modeling was applied to project disease trends.

Results

Globally, in 2021, there were 5.61 million new cases of PIAIO, 215,681 prevalent cases, 32,885 deaths, and 1.86 million DALYs lost in people aged 15–49 years. During 1990–2021, age-standardized incidence rate (ASIR) and prevalence rate (ASPR) showed a slight upward trend (AAPC 0.06% and 0.05%), but mortality (ASMR) and DALYs rates decreased significantly (AAPC − 0.80% and − 0.74%). High SDI regions had the highest ASIR (153.28/100,000) and ASPR (5.90/100,000), while Eastern Sub-Saharan Africa had the highest ASMR (3.54/100,000) and DALYs rate (181.53/100,000) globally. At national level, India carries the highest absolute burden, with the highest ASIR of 251.27/100,000 in Japan and the highest ASMR of 6.04/100,000 in Mozambique. Between 1990 and 2021, the ASMR and DALYs rates gradient showed a narrowing of absolute inequality, but relative inequality widened. The absolute number of new cases is projected to increase by 14.2% through 2036, with the ASMR declining by only 0.79 (95% UI: 0.39–1.19) per 100,000 persons-year.

Conclusions

Young and middle-aged PIAIO showed a global pattern of “high diagnosis in high-income regions and high mortality in low-income regions.” Although advances in surgical techniques have contributed to the decline in mortality, increasing incidence and persistent health inequalities in low SDI regions call for targeted interventions. This study fills the gap in evidence on the burden of disease in this population, and it is necessary to combine data from multiple sources to improve precise prevention and control strategies.