目的:卒中是全球重大的公共卫生负担。本研究旨在探讨脑卒中发病的趋势和规律,死亡率,从1990年到2019年,全球残疾调整寿命年(DALYs)和病死率(CFP)。
方法:年龄-时期-队列分析。
方法:使用2019年全球疾病负担研究的数据评估了全球卒中负担趋势。此外,采用分位数回归分析了卒中负担与社会人口统计学指数(SDI)之间的关系.年龄,我们使用年龄-时间段-队列分析估算了不同SDI组的卒中负担的时间段和队列模式.
结果:在1990年至2019年之间,中风发病率的年龄标准化率(ASR),全球死亡率和DALY显著下降,减少-16.89%(95%不确定区间[UI]:-18.41至-15.29),-36.43%(95%UI:-41.65至-31.20)和-35.23%(95%UI:-40.49至-30.49),分别。ASR在第75百分位数及以下的地区随着SDI的增加,ASR显着下降。2014年后,所有组的卒中发病率均有稳定或略有增加的周期效应。而死亡率,DALYs和CFP仅在高SDI组中增加。从1960-1964年队列开始,高SDI组的卒中发生率的队列效应保持不变。
结论:尽管高SDI地区的卒中负担较低,总体负担下降较快,最近的相对风险数据表明,这些地区卒中负担减轻的进展可能会减速.有必要采取更积极的措施,以减轻发病率最高的地区的中风负担,死亡率和DALYs,因为单靠增加SDI并不能减轻这些地区的负担。
OBJECTIVE: Stroke is a significant public health burden worldwide. This study aimed to explore the
trends and patterns of stroke incidence, mortality, disability-adjusted life years (DALYs) and
case-fatality percent (CFP) worldwide from 1990 to 2019.
METHODS: Age-period-cohort analysis.
METHODS: Trends in stroke burden worldwide were evaluated using data from the Global Burden of Disease 2019 study. In addition, the relationship between the burden of stroke and sociodemographic index (SDI) was examined by quantile regression. Age, period and cohort patterns in stroke burden across different SDI groups were estimated using age-period-cohort analysis.
RESULTS: Between 1990 and 2019, the age-standardised rates (ASRs) of stroke incidence, mortality and DALYs declined significantly worldwide, with decreases of -16.89% (95% uncertainty interval [UI]: -18.41 to -15.29), -36.43% (95% UI: -41.65 to -31.20) and -35.23% (95% UI: -40.49 to -30.49), respectively. Regions with ASRs in the 75th percentile and below experienced significant decreases in ASRs with increasing SDI. After 2014, there was a stable or slightly increased period effect for stroke incidence in all groups, while mortality, DALYs and CFP increased only in the high SDI group. The cohort effect of stroke incidence remained constant in the high SDI group from the 1960-1964 cohort onwards.
CONCLUSIONS: Although high SDI regions had a lower stroke burden and a faster overall decline in burden, the recent relative risk data suggest a potential deceleration in the progress of reducing stroke burden in these areas. There is a need for more active measures to reduce the stroke burden in areas with the highest incidence, mortality and DALYs, as increasing SDI alone cannot lower the burden in these regions.