Understanding the stroke burden in Saudi Arabia: Trends from 1990 to 2019 and forecasting through time series analysis.

OBJECTIVES

To describe age-standardized incidence and disability-adjusted life years (DALYs) of ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in the Kingdom of Saudi Arabia (KSA) from 1990 to 2019 and forecast these variables using the Global Burden of Diseases (GBD) data over the next years (2020-2030).

METHODS

Poisson regression models were employed to identify significant changes in incidence rate ratios (IRRs) and DALY rates for different stroke types. For time series models, the autoregressive integrated moving average (ARIMA) and exponential smoothing state space (ETS) models were used for forecasting.

RESULTS

The study demonstrated an increasing trend in the age-standardized incidence rate per 100,000 different types of strokes over the last 30 years, with a slight decrease in ICH and SAH types in 2015, followed by a continued increase. The prediction models indicated a sustained increase in the 3 types of strokes, accompanied by a decrease in DALYs. As regards DALYs, the trend for IS and ICH has been slowly and steadily increasing; however, there will be a modest decrease in DALYs rates for SAH during the next decade.

CONCLUSION

Stroke rates in KSA have increased over 3 decades, mainly among women and older individuals, and have a slow sustained increase over the forecasted period (2020-2030); thus, proactive strategies and healthcare interventions are required.