背景:脑出血(ICH)是由血管破裂引起的脑出血,是全球死亡和长期残疾的主要原因之一,特别是在低收入和中等收入国家。尽管发病率低于缺血性卒中,ICH带来了更大的社会和经济负担。据我们所知,自2021年全球疾病负担(GBD)报告发布以来,目前还没有关于ICH流行病学和趋势的全面更新.本研究旨在分析性别的影响,年龄,和社会人口统计学指数(SDI)关于ICH在全球的负担,区域,和国家层面。
方法:发病率数据,死亡,从GBD2021项目中提取了1990年至2021年的ICH残疾调整寿命年(DALYs)及其相关风险因素,包括203个国家和地区。此外,通过Joinpoint分析评估了总体脑出血负荷的时间趋势.
结果:2021年,全球有344.4万新的ICH病例,年龄标准化患病率为每10万人40.8人,与1990年相比下降了31.4%。2021年,ICH造成330.8万人死亡,年龄标准化死亡率为每10万人39.1人,自1990年以来减少了36.6%。全球范围内,ICH占794.57百万DALYs,年龄标准化的DALY率为每10万人92.4,自1990年以来下降了39.1%。区域,中亚,大洋洲,东南亚的ICH年龄标准化患病率最高,而澳大拉西亚,高收入的北美,西欧的利率最低。在全国范围内,所罗门群岛,蒙古,基里巴斯的年龄标准化患病率最高,而瑞士,新西兰,澳大利亚是最低的。高血压,吸烟,和环境污染被确定为ICH的主要危险因素。这项研究还验证了SDI和ICH负担之间的显著关联,随着SDI的增加,ICH的年龄标准化DALY率显著下降。
结论:尽管脑出血的负担减轻,在SDI较低的国家,它仍然是一个重大的公共卫生问题.预防策略应优先考虑高血压管理,空气质量改善,和控制吸烟,以进一步减轻脑出血的影响。
BACKGROUND: Intracerebral hemorrhage (ICH) results from the rupture of blood vessels causing bleeding within the brain and is one of the major causes of death and long-term disability globally, particularly in low- and middle-income countries. Despite having a lower incidence than ischemic stroke, ICH imposes a greater social and economic burden. To our knowledge, since the release of the 2021 Global Burden of Disease (GBD) report, there has been no comprehensive update on the epidemiology and trends of ICH. This study aims to analyze the impact of gender, age, and the Sociodemographic Index (SDI) on the burden of ICH at global, regional, and national levels.
METHODS: Data on the incidence, deaths, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project, encompassing 203 countries and regions. Furthermore, temporal trends of the global intracerebral hemorrhage burden were assessed through Joinpoint analysis.
RESULTS: In 2021, there were 3.444 million new cases of ICH worldwide, with an age-standardized prevalence rate of 40.8 per 100,000 people, representing a 31.4% decrease compared to 1990. In 2021, ICH caused 3.308 million deaths, with an age-standardized mortality rate of 39.1 per 100,000 people, a reduction of 36.6% since 1990. Globally, ICH accounted for 79.457 million DALYs, with an age-standardized DALY rate of 92.4 per 100,000 people, representing a 39.1% decrease since 1990. Regionally, Central Asia, Oceania, and Southeast Asia had the highest age-standardized prevalence rates of ICH, whereas Australasia, high-income North America, and Western Europe had the lowest rates. Nationally, the Solomon Islands, Mongolia, and Kiribati had the highest age-standardized prevalence rates, whereas Switzerland, New Zealand, and Australia had the lowest. Hypertension, smoking, and environmental pollution were identified as the primary risk factors for ICH. This study also validated the significant association between SDI and the burden of ICH, with the age-standardized DALY rate of ICH decreasing significantly as SDI increased.
CONCLUSIONS: Despite the decreasing burden of intracerebral hemorrhage, it remains a significant public health issue in countries with a lower SDI. Prevention strategies should prioritize hypertension management, air quality improvement, and smoking control to further mitigate the impact of intracerebral hemorrhage.