Epidemiology of stroke and transient ischemic attacks: Current knowledge and perspectives
Epidemiology of stroke and transient ischemic attacks: Current knowledge and perspectives
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DOI：
10.1016/j.neurol.2015.07.013
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发表时间：
2016-01-01
影响因子：
3
通讯作者：
Giroud, M.
中科院分区：
文献类型：
--
作者：
Bejot, Y.;Daubail, B.;Giroud, M.
由于世界人口的不断增长和老龄化，全球中风负担正在急剧增加。目前的流行病学数据表明，每年有1 690万人患中风，全球发病率为258/100 000/年，高收入和低收入国家之间存在显著差异，男性经年龄调整的发病率是女性的1.5倍。虽然一级预防有助于降低高收入国家的中风发病率，但所谓的“流行病学转变”也导致中低收入国家的发病率增加。此外，年轻人缺血性卒中的发病率正在上升，这表明需要在该年龄组进行特定的预防干预。中风幸存者的人数在1990年至2010年期间几乎翻了一番，现在已经达到3300万人。根据流行病学预测，到2030年，这一数字将上升到7 700万。在法国，2009年因急性脑血管事件住院的人数约为138，000人，占国家卫生总支出的3%。中风后的结果经常受到并发症的影响，包括运动障碍、痴呆、抑郁、疲劳和早期再住院和机构化的高风险，在社会经济成本方面具有不良后果。此外，全世界每年有590万人死于中风。最后，尽管许多分析性流行病学研究大大增加了我们对中风危险因素的了解，但最近的INTERSTROKE研究提供的证据表明，仅10个危险因素就占所有中风的88%。这些风险因素中有许多是可以改变的，这表明应该努力促进旨在降低中风风险的干预措施。目前仍在开发一种新的“大众方法”，旨在降低一个地区所有人的中风风险因素水平，而不管任何特定个体的风险水平。这种传播中风意识的有趣和创新的方式是基于使用国际验证的移动电话应用程序，该应用程序可以计算任何特定个体的中风风险，并且还包含一个部分来教育人们中风警告症状和体征。(C)2015年Elsevier Masson SAS。All rights reserved.
Because of the growing size and aging of the world's population, the global burden of stroke is increasing dramatically. Current epidemiological data indicate that 16.9 million people suffer a stroke each year, which represents a global incidence of 258/100,000/year, with marked differences between high- and low-income countries, and an age-adjusted incidence 1.5 times higher in men than in women. Although primary prevention has contributed to a decrease in stroke incidence in high-income countries, the so-called 'epidemiological transition' has led to an increase in incidence in middle-to-low-income countries as well. In addition, the incidence of ischemic stroke in young adults is on the rise, suggesting a need for specific preventative interventions in that age group. The number of stroke survivors almost doubled between 1990 and 2010, and has now reached 33 million people. According to epidemiological projections, this number will rise to 77 million by 2030. In France, the number of hospitalizations for an acute cerebrovascular event was about 138,000 in 2009, accounting for 3% of the total national health expenditure. Outcomes after stroke are frequently impaired by complications, including motor handicaps, dementia, depression, fatigue, and a high risk of early rehospitalization and institutionalization, with adverse consequences in terms of socioeconomic costs. In addition, there are 5.9 million stroke-related deaths worldwide every year. Finally, although many analytical epidemiological studies have considerably increased our knowledge of risk factors for stroke, the recent INTERSTROKE study provided evidence that 10 risk factors alone accounted for 88% of all strokes. Many of these risk factors are modifiable, which suggests that efforts should be made to promote interventions that aim to reduce the risk of stroke. A new 'mass approach' aiming to reduce the level of stroke risk factors in all people in a region, regardless of any given individual's level of risk, is currently still being developed. This interesting and innovative way to spread stroke awareness is based on the use of an internationally validated mobile-phone application that can calculate the risk of stroke for any given individual, and also contains a section to educate people on stroke warning symptoms and signs. (C) 2015 Elsevier Masson SAS. All rights reserved.