Global, regional, and national burden of stroke, 1990-2016

6533b86cfe1ef96bd12c82d6

RESEARCH PRODUCT

Global, regional, and national burden of stroke, 1990-2016

Johnson C Nguyen M Roth G Nichols E Alam T Abate D Abd-allah F Abdelalim A Abraha H Abu-rmeileh N Adebayo O Adeoye A Agarwal G Agrawal S Aichour A Aichour I Aichour M Alahdab F Ali R Alvis-guzman N Anber N Anjomshoa M Arabloo J Arauz A Arnlov J Arora A Awasthi A Banach M Barboza M Barker-collo S Barnighausen T Basu S Belachew A Belayneh Y Bennett D Bensenor I Bhattacharyya K Biadgo B Bijani A Bikbov B Bin Sayeed M Butt Z Lucero Cahuana-hurtado Carrero J Carvalho F Castaneda-orjuela C Castro F Catala-lopez F Chaiah Y Chiang P Choi J Hanne Christensen Chu D Cortinovis M Damasceno A Dandona L Dandona R Daryani A Davletov K De Courten B De La Cruz-gongora V Degefa M Dharmaratne S Diaz D Dubey M Duken E Edessa D Endres M Faraon E Farzadfar F Fernandes E Fischer F Flor L Ganji M Gebre A Gebremichael T Geta B Gezae K Gill P Gnedovskaya E Gomez-dantes H Goulart A Grosso G Guo Y Gupta R Haj-mirzaian A Haj-mirzaian A Hamidi S Hankey G Hassen H Hay S Hegazy M Heidari B Herial N Hosseini M Hostiuc S Irvani S Islam S Jahanmehr N Javanbakht M Jha R Jonas J Jozwiak J Jurisson M Kahsay A Kalani R Kalkonde Y Kamil T Kanchan T Karch A Karimi N Karimi-sari H Kasaeian A Kassa T Kazemeini H Kefale A Khader Y Khalil I Khan E Khang Y Khubchandani J Kim D Kim Y Kisa A Kivimaki M Koyanagi A Krishnamurthi R Kumar G Lafranconi A Lewington S Li S Lo W Lopez A Lorkowski S Lotufo P Mackay M Majdan M Majdzadeh R Majeed A Malekzadeh R Manafi N Mansournia M Mehndiratta M Mehta V Mengistu G Meretoja A Meretoja T Miazgowski B Miazgowski T Miller T Mirrakhimov E Mohajer B Mohammad Y Mohammadoo-khorasani M Mohammed S Mohebi F Mokdad A Mokhayeri Y Moradi G Morawska L Velasquez I Mousavi S Muhammed O Muruet W Naderi M Naghavi M Naik G Nascimento B Negoi R Nguyen C Nguyen L Nirayo Y Norrving B Noubiap J Ofori-asenso R Ogbo F Olagunju A Olagunju T Owolabi M Pandian J Patel S Perico N Piradov M Polinder S Postma M Poustchi H Prakash V Qorbani M Rafiei A Rahim F Rahimi K Rahimi-movaghar V Rahman M Rahman M Reis C Remuzzi G Renzaho A Ricci S Roberts N Robinson S Roever L Roshandel G Sabbagh P Safari H Safari S Safiri S Sahebkar A Zahabi S Samy A Santalucia P Santos I Santos J Milicevic M Sartorius B Sawant A Schutte A Sepanlou S Shafieesabet A Shaikh M Shams-beyranvand M Sheikh A Sheth K Shibuya K Shigematsu M Shin M Shiue I Siabani S Sobaih B Sposato L Sutradhar I Sylaja P Szoeke C Ao B Temsah M Temsah O Thrift A Tonelli M Topor-madry R Tran B Tran K Truelsen T Tsadik A Ullah I Uthman O Vaduganathan M Valdez P Vasankari T Vasanthan R Venketasubramanian N Vosoughi K Vu G Waheed Y Weiderpass E Weldegwergs K Westerman R Wolfe C Wondafrash D Xu G Yadollahpour A Yamada T Yatsuya H Yimer E Yonemoto N Yousefifard M Yu C Zaidi Z Zamani M Zarghi A Zhang Y Zodpey S Feigin V Vos T Murray C Gbd 2016 Stroke Collaborators

subject

Male Cost effectiveness IMPACT Global Health GUIDELINES 3124 Neurology and psychiatry Brain Ischemia Global Burden of Disease COST-EFFECTIVENESS 0302 clinical medicine Risk Factors Global health Prevalence Medicine 030212 general & internal medicine Stroke POPULATION Aged 80 and over RISK education.field_of_study Incidence (epidemiology)Mortality rate Incidence Age Factors Middle Aged PREVALENCE Stroke Female Life Sciences & Biomedicine Intracranial Hemorrhages Adult Population Clinical Neurology 03 medical and health sciences Humans education Aged Science & Technology Neurology & Neurosurgery business.industry 3112 Neurosciences Klinisk medicin 1103 Clinical Sciences medicine.disease GBD 2016 Stroke Collaborators Verbal autopsy TRANSIENT ISCHEMIC ATTACK Years of potential life lost Socioeconomic Factors Human medicine Neurosciences & Neurology Neurology (clinical)Clinical Medicine 1109 Neurosciences business PRIMARY PREVENTION 030217 neurology & neurosurgery Demography RC

description

Background: Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. Methods: We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. Findings: In 2016, there were 5·5 million (95% UI 5·3 to 5·7) deaths and 116·4 million (111·4 to 121·4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36·2% (−39·3 to −33·6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34·2% (−37·2 to −31·5), also with decreases in all SDI quintiles. There were 13·7 million (12·7 to 14·7) new stroke cases in 2016. Global age-standardised incidence declined by 8·1% (−10·7 to −5·5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80·1 million (74·1 to 86·3) prevalent cases of stroke globally in 2016; 41·1 million (38·0 to 44·3) in women and 39·0 million (36·1 to 42·1) in men. Interpretation: Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor.

year	journal	country	edition	language
2019-05-01	Lancet Neurology

10.1016/s1474-4422(19)30034-1 https://doi.org/10.1016/s1474-4422(19)30034-1