The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
University of California, Davis, California, 95616, USA.
BMC Public Health. 2024 Sep 6;24(1):2426. doi: 10.1186/s12889-024-19923-7.
Intracerebral hemorrhage (ICH) results from the rupture of blood vessels causing bleeding within the brain and is one of the major causes of death and long-term disability globally, particularly in low- and middle-income countries. Despite having a lower incidence than ischemic stroke, ICH imposes a greater social and economic burden. To our knowledge, since the release of the 2021 Global Burden of Disease (GBD) report, there has been no comprehensive update on the epidemiology and trends of ICH. This study aims to analyze the impact of gender, age, and the Sociodemographic Index (SDI) on the burden of ICH at global, regional, and national levels.
Data on the incidence, deaths, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project, encompassing 203 countries and regions. Furthermore, temporal trends of the global intracerebral hemorrhage burden were assessed through Joinpoint analysis.
In 2021, there were 3.444 million new cases of ICH worldwide, with an age-standardized prevalence rate of 40.8 per 100,000 people, representing a 31.4% decrease compared to 1990. In 2021, ICH caused 3.308 million deaths, with an age-standardized mortality rate of 39.1 per 100,000 people, a reduction of 36.6% since 1990. Globally, ICH accounted for 79.457 million DALYs, with an age-standardized DALY rate of 92.4 per 100,000 people, representing a 39.1% decrease since 1990. Regionally, Central Asia, Oceania, and Southeast Asia had the highest age-standardized prevalence rates of ICH, whereas Australasia, high-income North America, and Western Europe had the lowest rates. Nationally, the Solomon Islands, Mongolia, and Kiribati had the highest age-standardized prevalence rates, whereas Switzerland, New Zealand, and Australia had the lowest. Hypertension, smoking, and environmental pollution were identified as the primary risk factors for ICH. This study also validated the significant association between SDI and the burden of ICH, with the age-standardized DALY rate of ICH decreasing significantly as SDI increased.
Despite the decreasing burden of intracerebral hemorrhage, it remains a significant public health issue in countries with a lower SDI. Prevention strategies should prioritize hypertension management, air quality improvement, and smoking control to further mitigate the impact of intracerebral hemorrhage.
脑出血（ICH）是由于血管破裂导致脑内出血引起的，是全球，尤其是中低收入国家死亡和长期残疾的主要原因之一。尽管发病率低于缺血性中风，但脑出血造成的社会和经济负担更大。据我们所知，自 2021 年全球疾病负担（GBD）报告发布以来，尚无关于脑出血流行病学和趋势的全面更新。本研究旨在分析全球、区域和国家各级性别、年龄和社会人口指数（SDI）对脑出血负担的影响。
从 203 个国家和地区的 GBD 2021 项目中提取了 1990 年至 2021 年脑出血的发病率、死亡率和伤残调整生命年（DALY）及其相关危险因素的数据。此外，通过 Joinpoint 分析评估了全球脑出血负担的时间趋势。
2021 年，全球有 344.4 万例新的脑出血病例，标准化年龄患病率为每 10 万人 40.8 例，比 1990 年下降了 31.4%。2021 年，脑出血导致 330.8 万人死亡，标准化死亡率为每 10 万人 39.1 例，自 1990 年以来下降了 36.6%。全球范围内，脑出血占 7945.7 万人 DALY，标准化 DALY 率为每 10 万人 92.4 例，自 1990 年以来下降了 39.1%。在区域方面，中亚、大洋洲和东南亚的脑出血标准化年龄患病率最高，而澳大拉西亚、高收入北美和西欧的患病率最低。在国家层面上，所罗门群岛、蒙古和基里巴斯的标准化年龄患病率最高，而瑞士、新西兰和澳大利亚的标准化年龄患病率最低。高血压、吸烟和环境污染被确定为脑出血的主要危险因素。本研究还验证了 SDI 与脑出血负担之间的显著关联，随着 SDI 的增加，脑出血的标准化 DALY 率显著下降。
尽管脑出血负担有所减轻，但在 SDI 较低的国家，它仍然是一个重大的公共卫生问题。预防策略应优先考虑高血压管理、空气质量改善和吸烟控制，以进一步减轻脑出血的影响。
