1992年至2021年期间金砖国家及其他主要新兴经济体缺血性卒中负担的流行病学趋势和年龄-时期-队列效应

Epidemiological trends and age-period-cohort effects on ischemic stroke burden across the BRICS-plus from 1992 to 2021.

作者信息

Cheng Fangqun, Cheng Peiyu, Xie Shudong, Wang Hailing, Tang Ying, Liu Ying, Xiao Zhuo, Zhang Guixiang, Yuan Guangxiong, Wang Ke, Feng Can, Zhou Ying, Xia Hong, Wang Yan, Wu Yuhang

机构信息

Xiangtan Central Hospital, Xiangtan, China.

Transplantation Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

BMC Public Health. 2025 Jan 13;25(1):137. doi: 10.1186/s12889-025-21310-9.

BACKGROUND

Ischemic stroke, accounting for 85% of stroke cases, leads to severe disabilities and increased mortality. Its global incidence rose by 87.55% from 1990 to 2019, posing significant health and economic burdens. The BRICS-plus nations-Brazil, Russia, India, China, South Africa, and five others-represent a large global population, presenting unique public health challenges. This study aims to evaluate the epidemiological trends and variations in the burden of ischemic stroke across BRICS-plus nations in a timely manner.

METHODS

Data on the number, all-age rate, age-standardized rate, and relative change in ischemic stroke disability-adjusted life years (DALYs) from 1992 to 2021 within BRICS-plus were obtained from the Global Burden of Disease Study (GBD) 2021. Relationships between the DALYs rate and the Socio-demographic Index (SDI) were evaluated using Pearson correlation analyses. Additionally, age-period-cohort modeling was employed to estimate net drift, local drift, age, period, and cohort effects over the past three decades.

RESULTS

From 1992 to 2021, total DALYs due to ischemic stroke increased by 47.14%, while the age-standardized DALYs rate decreased by 33.79%. All BRICS-plus countries exhibited a declining trend in the age-standardized DALYs rate over the past three decades. Egypt reported the highest age-standardized DALYs rate (2,462.60 per 100,000 population) in 2021, whereas the most substantial reduction of 59.37% was observed in Brazil. The annual net drift in the ischemic stroke DALYs rate ranged from -3.04% for Brazil to -0.48% for Egypt among the ten countries. A significant positive correlation was observed between the DALYs rate of ischemic stroke and SDI values. Countries exhibited similar age effect patterns, with an increasing risk of DALYs rate with advancing age. Period and cohort effects highlighted declines in observed nations, indicating improved ischemic stroke management strategies.

CONCLUSION

The burden of ischemic stroke showed an overall declining trend across the BRICS-plus from 1992 to 2021, but persistent health inequalities between these countries were driven by socioeconomic disparities. Furthermore, it emphasizes the necessity for targeted interventions across age, period, and cohort dimensions to address the distinct challenges posed by ischemic stroke in these rapidly developing countries.

背景

缺血性中风占中风病例的85%，会导致严重残疾并增加死亡率。从1990年到2019年，其全球发病率上升了87.55%，带来了巨大的健康和经济负担。金砖五国加上巴西、俄罗斯、印度、中国、南非以及其他五个国家代表了全球很大一部分人口，呈现出独特的公共卫生挑战。本研究旨在及时评估金砖五国加上其他国家缺血性中风负担的流行病学趋势和变化。

方法

从《2021年全球疾病负担研究》（GBD 2021）中获取1992年至2021年金砖五国加上其他国家缺血性中风伤残调整生命年（DALYs）的数量、全年龄发病率、年龄标准化发病率以及相对变化的数据。使用Pearson相关分析评估DALYs率与社会人口指数（SDI）之间的关系。此外，采用年龄-时期-队列模型来估计过去三十年的净漂移、局部漂移、年龄、时期和队列效应。

结果

从1992年到2021年，缺血性中风导致的总DALYs增加了47.14%，而年龄标准化DALYs率下降了33.79%。在过去三十年中，所有金砖五国加上其他国家的年龄标准化DALYs率均呈下降趋势。埃及在2021年报告的年龄标准化DALYs率最高（每10万人口2462.60例），而巴西的降幅最大，达59.37%。在这十个国家中，缺血性中风DALYs率的年度净漂移范围从巴西的-3.04%到埃及的-0.48%。观察到缺血性中风的DALYs率与SDI值之间存在显著正相关。各国呈现出相似的年龄效应模式，随着年龄增长，DALYs率风险增加。时期和队列效应突出显示了所观察国家的下降趋势，表明缺血性中风管理策略有所改善。