283 The global burden of decubitus ulcers, 1990-2015

Introduction: The Global Burden of Disease Study (GBD) 2015 is a systematic scientific effort to quantify the comparative magnitude of global health loss. This study presents GBD 2015 results for decubitus ulcer. Design and Setting: Decubitus ulcer epidemiologic data sources were derived from an extensive literature search, hospital insurance data, and vital registration records. Data sources were analyzed with a Bayesian meta-regression modeling tool, DisMod-MR 2.1, to yield prevalence estimates. These were combined with disability weights to produce years lived with disability (YLDs). Deaths by age group were multiplied with reference life expectancy to generate years of life lost (YLLs). YLDs and YLLs were summed to yield DALYs for 195 countries divided into 21 world regions, both sexes, 20 age groups, and years 1990-2015. Main Outcomes and Measures: Disability-adjusted life-years (DALYs) in 195 countries. Results: The world regions of Southern Sub-Saharan Africa, Eastern Sub-Saharan Africa, Oceania, Southern Latin America, and Central Sub-Saharan Africa had the greatest burden and death from decubitus ulcers. The five individual countries with greatest decubitus ulcer burden were American Samoa, The Bahamas, Barbados, Bahrain, and Saint Vincent and the Grenadines. Of 65,980 deaths registered in the USA from 1980-2014 with decubitus ulcer as an underlying cause, 99.2% had additional causes listed. Conclusion and Relevance: Our findings are at least partially explained by a convergence of high obesity prevalence and inadequate healthcare infrastructure. The substantial health and economic burden of decubitus ulcers worldwide highlight the need for effective prevention efforts. GBD results can help shape research and public policy.