Analysis of disease burden and trend prediction of pediatric appendicitis in China based on GBD data

doi:10.3969/j.issn.1674-8115.2026.08.013

Abstract

Abstract:

Objective ·To systematically evaluate the changing trends of appendicitis disease burden among the children in China from 1990 to 2023, analyze the driving factors underlying burden changes, and predict the disease burden trends from 2024 to 2050. Methods ·Based on the data from Global Burden of Disease Study 2023 (GBD 2023), indicators including incidence, mortality, and disability-adjusted life years (DALYs) of appendicitis in Chinese children aged 0‒14 years were extracted. Age-standardized indicators were adopted to assess the level of disease burden; the estimated annual percentage change (EAPC) was used to evaluate temporal trends, and differences by gender and age were explored were explored. The Das Gupta decomposition method was applied to quantify the independent contributions of population growth, population age structure, and epidemiological factors to changes in disease burden. The Bayesian age-period-cohort (BAPC) model was employed to predict the trends of core indicators from 2024 to 2050. Results ·From 1990 to 2023, the number of incident appendicitis cases among Chinese children decreased from 260 374 (95% UI 166 444‒396 374) to 187 216 (95% UI 118 429‒289 624), with a slight decline in the age-standardized incidence rate (ASIR) (EAPC=-0.72%). The number of deaths fell from 285 (95% UI 116‒464) to 36 (95% UI 20‒60), and DALYs dropped from 26 708 (95% UI 13 092‒41 742) to 5 124 (95% UI 3 417‒7 345). The age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) decreased significantly, with EAPCs of -6.48% and -4.88%, respectively. The ASIR was highest among children aged 10‒14 years, while the ASMR was relatively higher among children under 10 years old. The ASIR was consistently higher in boys than in girls. The ASMR in boys was lower than that in girls before 2009 but exceeded that in girls thereafter; similarly, the ASDR in boys was lower than that in girls before 2006 but became higher thereafter. Decomposition analysis showed that the decline in incidence burden was driven by population growth and epidemiological changes, while the reductions in mortality and disability burden were mainly driven by epidemiological improvements. The BAPC model predicted that the ASIR, ASMR, and ASDR would continue to decline from 2024 to 2050, but a slight rebound might occur after 2045. Conclusion ·Between 1990 and 2023, the mortality and disability burden of appendicitis among Chinese children was significantly reduced, whereas the decline in incidence burden was relatively limited. Differences in disease burden existed across age groups and genders, and the overall disease burden may rise slightly in the future.

Key words: child, appendicitis, disease burden, disability-adjusted life year (DALY), trend prediction

CLC Number:

R179

Chen Dawei, Sun Mingming. Analysis of disease burden and trend prediction of pediatric appendicitis in China based on GBD data[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(8): 1124-1133.

Figures/Tables 9

TrendMD

References 21

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Gender	1990		2023		EAPC (95% CI)/%
Gender	Case (95% UI)/n	ASIR (95% UI)/×10^-5	Case (95% UI)/n	ASIR (95% UI)/×10^-5	EAPC (95% CI)/%
Total	260 374 (166 444‒396 374)	82.86 (47.95‒133.51)	187 216 (118 429‒289 624)	69.46 (40.06‒112.20)	-0.72 (-0.83‒ -0.61)
Male	149 510 (95 813‒226 402)	91.74 (53.81‒147.16)	109 080 (69 530‒167 909)	76.11 (43.89‒122.95)	-0.70 (-0.87‒ -0.54)
Female	110 864 (70 221‒170 143)	73.28 (41.56‒119.91)	78 136 (48 907‒121 714)	61.91 (35.83‒101.23)	-0.77 (-0.86‒ -0.69)

Gender	1990		2023		EAPC (95% CI)/%
Gender	Case (95% UI)/n	ASIR (95% UI)/×10^-5	Case (95% UI)/n	ASIR (95% UI)/×10^-5	EAPC (95% CI)/%
Total	260 374 (166 444‒396 374)	82.86 (47.95‒133.51)	187 216 (118 429‒289 624)	69.46 (40.06‒112.20)	-0.72 (-0.83‒ -0.61)
Male	149 510 (95 813‒226 402)	91.74 (53.81‒147.16)	109 080 (69 530‒167 909)	76.11 (43.89‒122.95)	-0.70 (-0.87‒ -0.54)
Female	110 864 (70 221‒170 143)	73.28 (41.56‒119.91)	78 136 (48 907‒121 714)	61.91 (35.83‒101.23)	-0.77 (-0.86‒ -0.69)

Gender	1990		2023		EAPC (95% CI)/%
Gender	Case (95% UI)/n	ASMR (95% UI)/×10^-5	Case (95% UI)/n	ASMR (95% UI)/×10^-5	EAPC (95% CI)/%
Total	285 (116‒464)	0.09 (0.04‒0.15)	36 (20‒60)	0.01 (0.01‒0.02)	-6.48 (-7.04‒ -5.91)
Male	133 (24‒234)	0.08 (0.01‒0.15)	20 (9‒41)	0.01 (0.01‒0.03)	-5.49 (-6.01‒ -4.96)
Female	152 (35‒334)	0.10 (0.02‒0.22)	16 (7‒37)	0.01 (0.01‒0.03)	-6.93 (-7.50‒ -6.36)

Gender	1990		2023		EAPC (95% CI)/%
Gender	Case (95% UI)/n	ASMR (95% UI)/×10^-5	Case (95% UI)/n	ASMR (95% UI)/×10^-5	EAPC (95% CI)/%
Total	285 (116‒464)	0.09 (0.04‒0.15)	36 (20‒60)	0.01 (0.01‒0.02)	-6.48 (-7.04‒ -5.91)
Male	133 (24‒234)	0.08 (0.01‒0.15)	20 (9‒41)	0.01 (0.01‒0.03)	-5.49 (-6.01‒ -4.96)
Female	152 (35‒334)	0.10 (0.02‒0.22)	16 (7‒37)	0.01 (0.01‒0.03)	-6.93 (-7.50‒ -6.36)

Gender	1990		2023		EAPC (95% CI)/%
Gender	DALYs (95% UI)	ASDR (95% UI)/×10^-5	DALYs (95% UI)	ASDR (95% UI)/×10^-5	EAPC (95% CI)/%
Total	26 708 (13 092‒41 742)	8.40 (3.97‒13.81)	5 124 (3 417‒7 345)	1.97 (1.24‒2.99)	-4.88 (-5.16‒ -4.60)
Male	12 808 (3 671‒21 085)	7.74 (2.26‒13.21)	2 927 (1 744‒4 617)	2.10 (1.18‒3.56)	-4.35 (-4.62‒ -4.08)
Female	13 900 (4 174‒29 004)	9.13 (2.62‒18.7)	2 198 (1 346‒3 828)	1.82 (1.03‒3.31)	-5.49 (-5.80‒ -5.18)