中国及全球不同 SDI 地区的卒中负担。

Burden of stroke in China and the different SDI regions over the world.

机构信息

School of Public Health, Weifang Medical University, Weifang, China.

ZIBO TCM- INTEGRATED HOSPITAL, Zibo, China.

出版信息

J Glob Health. 2023 Dec 22;13:04169. doi: 10.7189/jogh.13.04169.

DOI:10.7189/jogh.13.04169

PMID:38131457

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10740341/

Abstract

BACKGROUND

Stroke is a significant global health issue, ranking as the second leading cause of death and the third leading cause of death and disability combined. This study aimed to examine the changes and differences in stroke burden from 1990 to 2019 in China and various global socio-demographic index (SDI) regions.

METHODS

Data were obtained from the Global Burden of Diseases Study 2019, which included the incidence, prevalence, mortality, disability-adjusted life years (DALY), years of life with disability (YLD), and years of life lost (YLL) of stroke. The change trend of stroke burden was assessed based on age-standardised rates per 100 000 person-years and estimated annual percentage changes. The average annual rate of change in stroke burden was analysed using the average annual percentage change from 1990 to 2019. Pearson correlation analysis was used to explore the strength and direction of the correlation between stroke burden and SDI.

RESULTS

Regions with high SDI showed the largest decline in age-standardised incidence, death, DALY, YLD, and YLL rates of stroke from 1990 to 2019. China experienced the largest increase in age-standardised prevalence and YLD rates of stroke from 1990 to 2019. There were significant differences in the average annual percent change in stroke burden among the majority of SDI regions. The burden for stroke at the national level was inversely correlated with SDI, despite some exceptions (Incidence: R = -0.417, P < 0.001; prevalence: R = -0.297, P < 0.001; mortality: R = -0.510, P < 0.001; DALY: R = -0.550, P < 0.001; YLD: R = -0.125, P = 0.075; YLL: R = -0.569, P < 0.001).

CONCLUSIONS

There were significant differences in the stroke burden across different regions with varying SDI levels from 1990 to 2019. The age-standardised prevalence rate and attributable disability burden of stroke remain substantial in different SDI regions, making it a major contributor to the overall disease burden. The severe burden of stroke highlights the importance of primary and secondary stroke-prevention strategies. Therefore, future strategies to prevent and reduce the burden of stroke should be formulated and implemented according to the SDI of each country.

摘要

背景

中风是一个重大的全球健康问题，是全球第二大致死原因，也是导致死亡和残疾的第三大原因。本研究旨在探讨 1990 年至 2019 年中国和全球不同社会人口指数（SDI）地区中风负担的变化和差异。

方法

数据来自 2019 年全球疾病负担研究，包括中风的发病率、患病率、死亡率、伤残调整生命年（DALY）、残疾生命年（YLD）和生命损失年（YLL）。基于每 10 万人年标准化率和估计的年百分比变化，评估中风负担的变化趋势。使用 1990 年至 2019 年的平均年百分比变化分析中风负担的平均年变化率。采用 Pearson 相关分析探讨中风负担与 SDI 之间的相关性的强度和方向。

结果

高 SDI 地区的年龄标准化发病率、死亡率、DALY、YLD 和 YLL 下降幅度最大。中国在 1990 年至 2019 年期间，年龄标准化患病率和 YLD 上升幅度最大。在大多数 SDI 地区，中风负担的平均年百分比变化存在显著差异。国家一级的中风负担与 SDI 呈负相关，但也存在一些例外（发病率：R=−0.417，P<0.001；患病率：R=−0.297，P<0.001；死亡率：R=−0.510，P<0.001；DALY：R=−0.550，P<0.001；YLD：R=−0.125，P=0.075；YLL：R=−0.569，P<0.001）。