Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030

Abstract

Background: Hernias, particularly inguinal, femoral, and abdominal, present a global health challenge. While the global burden of disease (GBD) study offers insights, systematic analyses of hernias remain limited. This research utilizes the GBD dataset to explore hernia implications, combining current statistics with 2030 projections and frontier analysis.

Methods: We analyzed data from the 2019 GBD Study, focusing on hernia-related metrics: prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories, grouped into 21 GBD regions by the socio-demographic index (SDI). Data analysis encompassed relative change calculations, as well as annual percentage change (APC) and average annual percentage change (AAPC), both of which are based on joinpoint regression analysis. The study additionally employed frontier analysis and utilized the Bayesian age-period-cohort model for predicting trends up to 2030. Analyses utilized R version 4.2.3.

Results: From 1990 to 2019, the global prevalence of hernia cases surged by 36%, reaching over 32.5 million, even as age-standardized rates declined. A similar pattern was seen in mortality and DALYs, with absolute figures rising but age-standardized rates decreasing. Gender data between 1990 and 2019 showed consistent male dominance in hernia prevalence, even as rates for both genders fell. Regionally, Andean Latin America had the highest prevalence, with Central Sub-Saharan Africa and South Asia noting significant increases and decreases, respectively. Frontier analyses across 204 countries and territories linked higher SDIs with reduced hernia prevalence. Yet, some high SDI countries, like Japan and Lithuania, deviated unexpectedly. Predictions up to 2030 anticipate increasing hernia prevalence, predominantly in males, while age-standardized death rates and age-standardized DALY rates are expected to decline.

Conclusions: Our analysis reveals a complex interplay between socio-demographic factors and hernia trends, emphasizing the need for targeted healthcare interventions. Despite advancements, vigilance and continuous research are essential for optimal hernia management globally.