Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study.
Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study.
复制标题
DOI：
10.1159/000441085
复制
发表时间：
2015
影响因子：
5.7
通讯作者：
GBD 2013 Stroke Panel Experts Group
中科院分区：
文献类型：
--
作者：
Feigin VL;Krishnamurthi RV;Parmar P;Norrving B;Mensah GA;Bennett DA;Barker-Collo S;Moran AE;Sacco RL;Truelsen T;Davis S;Pandian JD;Naghavi M;Forouzanfar MH;Nguyen G;Johnson CO;Vos T;Meretoja A;Murray CJ;Roth GA;GBD 2013 Writing Group;GBD 2013 Stroke Panel Experts Group
全球脑卒中流行病学正在迅速变化。尽管在过去二十年中，世界范围内的年龄标准化中风死亡率有所下降，但每年患中风、承受中风后果并死于中风的绝对人数正在增加。定期更新当前卒中负担水平对于提高我们对卒中流行病学的认识以及促进组织和规划循证卒中护理非常重要。估计1990-2013年188个国家缺血性卒中（IS）和出血性卒中（HS）的发病率、患病率、死亡率、残疾调整生命年（DALYs）和残疾生活年（YLDs）及其趋势。使用所有可用的死亡率和卒中发病率、患病率和超额死亡率数据估计卒中发病率、患病率、死亡率、DALYs和YLDs。采用了统计模型和国家层面的协变量数据，并对所有比率进行了全球人口年龄标准化。所有的估计值都有95%的不确定区间（UI）。2013年，全球有近2570万中风幸存者（71%患有IS）， 650万人死于中风（51%死于IS）， 1.13亿人因中风死亡（58%死于IS）， 1030万例新发中风（67%死于IS）。1990-2013年期间，IS造成的伤残调整生命年的绝对数量、IS和HS造成的死亡人数、IS和HS的幸存者和事件事件的绝对数量都有显著增加。中风负担的优势仍然存在于发展中国家，占中风死亡人数的75.2%，占中风相关伤残调整年的81.0%。在全球范围内，卒中相关DALYs和卒中死亡占所有疾病的比例贡献从1990年（3.54% [95% UI 3.11-4.00%]和9.66% [95% UI 8.47-10.70%]）增加到2013年（4.62% [95% UI 4.01-5.30%]和11.75% [95% UI 10.45-13.31%]），但在发达国家和发展中国家存在分化趋势，发展中国家的DALYs和死亡人数显著增加。在发达国家，DALYs和中风死亡的比例贡献没有可测量的变化。全球卒中负担继续在全球范围内增加。迫切需要更有效的中风预防和管理战略，以制止并最终扭转中风大流行，同时应优先考虑普及有组织的中风服务。
Global stroke epidemiology is changing rapidly. Although age-standardised rates of stroke mortality have decreased worldwide in the past two decades, the absolute numbers of people who have a stroke every year, live with the consequences of stroke, and die from their stroke are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. To estimate incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and years lived with disability (YLDs), and their trends for ischaemic stroke (IS) and haemorrhagic stroke (HS) for 188 countries from 1990–2013. Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed and all rates were age-standardised to a global population. All estimated were produced with 95% uncertainty intervals (UI). In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS), and 10.3 million new strokes (67% IS). Over the 1990–2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% [95% UI 3.11–4.00%] and 9.66% [95% UI 8.47–10.70%]) to 2013 (4.62% [95% UI 4.01–5.30%] and 11.75% [95% UI 10.45–13.31%], respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority.