Abebe Tamrat Befekadu, Morton Jedidiah I, Ilomaki Jenni, Ademi Zanfina
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia,
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Neuroepidemiology. 2024;58(6):449-459. doi: 10.1159/000538800. Epub 2024 Apr 10.
Projections of the future burden of ischemic stroke (IS) has not been extensively reported for the Australian population; the availability of such data would assist in health policy planning, clinical guideline updates, and public health.
First, we estimated the lifetime risk of IS (from age 40 to 100 years) using a multistate life table model. Second, a dynamic multistate model was constructed to project the burden of IS for the whole Australian population aged between 40 and 100 years over a 20-year period (2019-2038). Data for the study were primarily sourced from a large, representative Victorian linked dataset based on the Victorian Admitted Episode Dataset and National Death Index. The model projected prevalent and incident cases of nonfatal IS, fatal IS, and years of life lived (YLL) with and without IS. The YLL outcome was discounted by 5% annually; we varied the discounting rate in scenario analyses.
The lifetime risk of IS from age 40 years was estimated as 15.5% for males and 14.0% for females in 2018. From 2019 to 2038, 644,208 Australians were projected to develop incident IS (564,922 nonfatal and 79,287 fatal). By 2038, the model projected there would be 358,534 people with prevalent IS, 35,554 people with incident nonfatal IS and 5,338 people with fatal IS, a 14.2% (44,535), 72.9% (14,988), and 106.3% (2,751) increase compared to 2019 estimations, respectively. Projected YLL (with a 5% discount rate) accrued by the Australian population were 174,782,672 (84,251,360 in males and 90,531,312 in females), with 4,053,794 YLL among people with IS (2,320,513 in males, 1,733,281 in females).
The burden of IS was projected to increase between 2019 and 2038 in Australia. The outcomes of the model provide important information for decision-makers to design strategies to reduce stroke burden.
关于澳大利亚人群未来缺血性中风（IS）负担的预测尚未有广泛报道；此类数据的可得性将有助于卫生政策规划、临床指南更新及公共卫生工作。
首先，我们使用多状态生命表模型估计了IS的终生风险（从40岁到100岁）。其次，构建了一个动态多状态模型，以预测20年期间（2019 - 2038年）40至100岁澳大利亚全体人群的IS负担。该研究的数据主要来源于一个基于维多利亚州住院病例数据集和国家死亡指数的大型、具有代表性的维多利亚州关联数据集。该模型预测了非致命性IS、致命性IS的现患和新发病例，以及有和没有IS情况下的生命年数（YLL）。YLL结果按每年5%进行贴现；我们在情景分析中改变了贴现率。
2018年，40岁起的IS终生风险估计男性为15.5%，女性为14.0%。从2019年到2038年，预计644,208名澳大利亚人将发生新发IS（564,922例非致命性和79,287例致命性）。到2038年，该模型预测将有358,534例IS现患病例、35,554例新发非致命性IS病例和5,338例致命性IS病例，与2019年的估计数相比，分别增加了14.2%（44,535例）、72.9%（14,988例）和106.3%（2,751例）。澳大利亚人群预计的YLL（贴现率为5%）为174,782,672（男性84,251,360，女性90,531,312），其中IS患者的YLL为4,053,794（男性2,320,513，女性1,733,281）。
预计2019年至2038年澳大利亚的IS负担将会增加。该模型的结果为决策者设计减轻中风负担的策略提供了重要信息。
