TY - JOUR
T1 - Global, regional, and national burden of stroke, 1990–2016
T2 - a systematic analysis for the Global Burden of Disease Study 2016
AU - GBD 2016 Stroke Collaborators
AU - Johnson, Catherine Owens
AU - Nguyen, Minh
AU - Roth, Gregory A.
AU - Nichols, Emma
AU - Alam, Tahiya
AU - Abate, Degu
AU - Abd-Allah, Foad
AU - Abdelalim, Ahmed
AU - Abraha, Haftom Niguse
AU - Abu-Rmeileh, Niveen Me
AU - Adebayo, Oladimeji M.
AU - Adeoye, Abiodun Moshood
AU - Agarwal, Gina
AU - Agrawal, Sutapa
AU - Aichour, Amani Nidhal
AU - Aichour, Ibtihel
AU - Aichour, Miloud Taki Eddine
AU - Alahdab, Fares
AU - Ali, Raghib
AU - Alvis-Guzman, Nelson
AU - Anber, Nahla Hamed
AU - Anjomshoa, Mina
AU - Arabloo, Jalal
AU - Arauz, Antonio
AU - Ärnlöv, Johan
AU - Arora, Amit
AU - Awasthi, Ashish
AU - Banach, Maciej
AU - Barboza, Miguel A.
AU - Barker-Collo, Suzanne Lyn
AU - Bärnighausen, Till Winfried
AU - Basu, Sanjay
AU - Belachew, Abate Bekele
AU - Belayneh, Yaschilal Muche
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Bhattacharyya, Krittika
AU - Biadgo, Belete
AU - Bijani, Ali
AU - Bikbov, Boris
AU - Bin Sayeed, Muhammad Shahdaat
AU - Butt, Zahid A.
AU - Cahuana-Hurtado, Lucero
AU - Carrero, Juan J.
AU - Carvalho, Félix
AU - Castañeda-Orjuela, Carlos A.
AU - Castro, Franz
AU - Catalá-López, Ferrán
AU - Chaiah, Yazan
AU - Chiang, Peggy Pei Chia
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85063992632
U2 - 10.1016/S1474-4422(19)30034-1
DO - 10.1016/S1474-4422(19)30034-1
M3 - Artículo
C2 - 30871944
AN - SCOPUS:85063992632
SN - 1474-4422
VL - 18
SP - 439
EP - 458
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 5
ER -
SDG 3 Good Health and Well-being