Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study

被引：1017

作者：

Feigin, Valery L. ^{[1
]}

Krishnamurthi, Rita V. ^{[1
]}

Parmar, Priya ^{[1
]}

Norrving, Bo ^{[3
]}

Mensah, George A. ^{[10
,11
]}

Bennett, Derrick A. ^{[4
,5
]}

Barker-Collo, Suzanne ^{[2
]}

Moran, Andrew E. ^{[12
]}

Sacco, Ralph L. ^{[13
]}

Truelsen, Thomas ^{[6
]}

Davis, Stephen ^{[7
]}

Pandian, Jeyaraj Durai ^{[9
]}

Naghavi, Mohsen ^{[14
]}

Forouzanfar, Mohammad H. ^{[14
]}

Nguyen, Grant ^{[15
,16
]}

Johnson, Catherine O. ^{[15
,16
]}

Vos, Theo ^{[14
]}

Meretoja, Atte ^{[8
]}

Murray, Christopher J. L. ^{[14
]}

Roth, Gregory A. ^{[16
,17
]}

Abd-Allah, Foad ^{[18
]}

Abera, Semaw Ferede ^{[19
]}

Akinyemi, Rufus Olusola ^{[20
]}

Salman, Rustam Al-Shahi ^{[21
]}

Anderson, Craig S. ^{[22
]}

Bahit, Maria Cecilia ^{[23
]}

Banerjee, Amitava ^{[24
]}

Basu, Sanjay ^{[25
]}

Beauchamp, Norman J. ^{[26
]}

Bornstein, Natan M. ^{[27
]}

Brainin, Michael ^{[28
,29
]}

Cabral, Norberto Luiz ^{[30
]}

Campos-Nonato, Ismael ^{[31
]}

Caso, Valeria ^{[32
]}

Catala-Lopez, Ferrán ^{[33
]}

Chowdhury, Rajiv ^{[34
]}

Christensen, Hanne K. ^{[35
,36
]}

Connor, Myles D. ^{[37
]}

deVeber, Gabrielle ^{[38
,39
]}

Dharmaratne, Samath D. ^{[40
]}

Dokova, Klara ^{[41
]}

Donnan, Geoffrey ^{[42
,43
]}

Endres, Matthias ^{[44
]}

Fernandes, Jefferson Gomes ^{[45
]}

Gankpe, Fortune ^{[46
]}

Geleijnse, Johanna M. ^{[47
]}

Gillium, Richard F. ^{[48
,49
]}

Giroud, Maurice ^{[50
]}

Hamadeh, Randah R. ^{[51
]}

Hankey, Graeme J. ^{[52
,53
]}

机构：

[1] Auckland Univ Technol, Natl Inst Stroke & Appl Neurosci, Auckland, New Zealand

[2] Univ Auckland, Sch Psychol, Clin Training Programme, Auckland 1, New Zealand

[3] Lund Univ, Dept Clin Sci, Neurol, Lund, Sweden

[4] Univ Oxford, Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Oxford, England

[5] Univ Oxford, Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Oxford, England

[6] Univ Copenhagen, Rigshosp, Dept Neurol, DK-2100 Copenhagen, Denmark

[7] Univ Melbourne, Translat Neurosci, Parkville, Vic 3052, Australia

[8] Univ Melbourne, Royal Melbourne Hosp L4C, Parkville, Vic 3052, Australia

[9] Christian Med Coll & Hosp, Dept Neurol, Ludhiana, Punjab, India

[10] NHLBI, Ctr Translat Res & Implementat Sci, NIH, Bethesda, MD 20892 USA

[11] NHLBI, Div Cardiovasc Sci, NIH, Bethesda, MD 20892 USA

[12] Columbia Univ, Div Gen Med, New York, NY USA

[13] Univ Miami, Miller Sch Med, Dept Neurol, Miami, FL 33136 USA

[14] Univ Washington, Sch Med & Publ Hlth, Dept Global Hlth, Seattle, WA 98195 USA

[15] Univ Washington, Sch Med & Publ Hlth, Dept Global Hlth, Seattle, WA 98195 USA

[16] Univ Washington, Sch Med, Inst Hlth Metr & Evaluat, Seattle, WA USA

[17] Univ Washington, Sch Med, Div Cardiol, Seattle, WA USA

[18] Cairo Univ, Dept Neurol, Cairo, Egypt

[19] Mekelle Univ, Coll Hlth Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Mekele, Ethiopia

[20] Univ Ibadan, Coll Med, Inst Adv Med Res & Training, Ibadan, Nigeria

[21] Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland

[22] Univ Sydney, Royal Prince Alfred Hosp, George Inst Global Hlth, Sydney, NSW, Australia

[23] INECO Neurociencias Rosario, Dept Cardiol, Rosario, Santa Fe, Argentina

[24] UCL, Farr Inst Hlth Informat Res, London, England

[25] Stanford Univ, Sch Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA

[26] Univ Washington, Dept Radiol, Seattle, WA 98195 USA

[27] Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel

[28] Danube Univ Krems, Dept Clin Neurol, Krems, Austria

[29] Karl Landsteiner Univ, Krems, Austria

[30] Univ Regiao Joinville, Clin Neurol Joinville, Joinville, Brazil

[31] Harvard Sch Publ Hlth, Dept Nutr, Boston, MA USA

[32] Univ Perugia, Stroke Unit, Perugia, Italy

[33] Univ Valencia, CIBERSAM INCLIVA, Dept Med, Valencia, Spain

[34] Univ Cambridge, Sch Clin Med, Dept Publ Hlth & Primary Care, Cambridge, England

[35] Univ Copenhagen, Copenhagen, Denmark

[36] Bispebjerg Hosp, Copenhagen, Denmark

[37] Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland

[38] Univ Toronto, Childrens Stroke Program, Div Neurol, Toronto, ON, Canada

[39] Hosp Sick Children, Res Inst, Toronto, ON, Canada

[40] Univ Peradeniya, Fac Med, Dept Community Med, Peradeniya, Sri Lanka

[41] Med Univ Varna, Fac Publ Hlth, Dep Soc Med & Hlth Care Org, Varna, Bulgaria

[42] Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Austin Hosp Campus, Parkville, Vic, Australia

[43] Univ Melbourne, Sch Neurol, Austin Hosp Campus, Parkville, Vic, Australia

[44] Charite Univ Med Berlin, Klin & Hochschulambulanz Neurol, Berlin, Germany

[45] German Hosp Oswaldo Cruz, Sch Hlth Edu cation & Sci, Sao Paulo, Brazil

[46] CHU Hassan II, Fes, Morocco

[47] Wageningen Univ, Div Human Nutr Epidemiol, Wageningen, Netherlands

[48] Howard Univ, Coll Med, Dept Internal Med, Washington, DC USA

[49] Howard Univ, Dept Community & Family Med, Coll Med, Washington, DC USA

[50] Serv Neurol, Dijon Stroke Reg, Dijon, France

来源：

NEUROEPIDEMIOLOGY | 2015年 / 45卷 / 03期

关键词：

Stroke; Ischemic stroke; Hemorrhagic stroke; Global burden; GBD; 2013; REGIONAL BURDEN; HYPERTENSION; DISEASE; RISK; MULTIMORBIDITY; COMMUNITY; CARE;

D O I：

10.1159/000441085

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or 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. Objectives: This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. Methodology: 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-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). Results: 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), respectively) 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. Conclusion: 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. (C) 2015 S. Karger AG, Basel

引用

页码：161 / 176

页数：16

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