Abstract: Objective To analyze the disease burden of intestinal obstruction in China from 1990 to 2021, investigate its changing trends, and forecast the future disease burden for the period of 2022-2035. Methods Data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of intestinal obstruction in China from 1990 to 2021 were extracted and analyzed from the Global Burden of Disease (GBD) 2021 database. The Joinpoint regression model was employed to analyze trends in the disease burden, while the Autoregressive Integrated Moving Average (ARIMA) model was utilized to predict the disease burden from 2022 to 2035. Results In comparison to 1990, the year 2021 witnessed a 37.75% increase in the number of incident cases of intestinal obstruction in China, with a corresponding 13.90% rise in the incidence rate. The number of prevalent cases increased by 34.97%, and the prevalence rate rose by 11.60%. Conversely, the age-standardized incidence rate and age-standardized prevalence rate decreased by 9.70% and 9.96%, respectively. The number of deaths, mortality rate, and age-standardized mortality rate declined by 21.17%, 34.82%, and 64.98%, respectively. Furthermore, DALYs, the DALY rate, and the age-standardized DALY rate decreased by 64.75%, 70.85%, and 73.93%, respectively. When benchmarked against global and different Socio-Demographic Index (SDI) regions, China's age-standardized incidence and prevalence rates of intestinal obstruction were at a comparatively high global level. However, its age-standardized mortality and DALY rates were among the lowest globally. The Joinpoint regression model indicated a significant decreasing trend in the age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized DALY rate for intestinal obstruction in China from 1990 to 2021, with respective Average Annual Percent Changes (AAPCs) of -0.32%, -0.34%, -3.37%, and -4.22% (all P<0.001). The disease burden was higher in males than in females, and was particularly severe in the population aged 70 years and older. The ARIMA model forecasts an upward trend in the number of incident cases, prevalent cases, incidence rate, and prevalence rate of intestinal obstruction in China from 2022 to 2035. Conclusion The disease burden of intestinal obstruction in China remained at a high level between 1990 and 2021. Males and individuals aged 70 years and older represent high-risk populations. The burden of incident and prevalent cases of intestinal obstruction is projected to increase from 2022 to 2035. It is imperative to formulate targeted medical policies and implement necessary interventions, with a particular focus on enhancing prevention and intervention strategies for high-risk groups.

Key words: Intestinal obstruction, Disease burden, Incidence prediction, Joinpoint regression model, Time series analysis