Xu Minghong, Tang Chao, Shen Yongkai, Zhang Yinan, Bao Long
Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
Department of Neurosurgery, General Hospital of Fushun Mining Bureau of Liaoning Health Industry Group, Fushun, China.
Front Neurol. 2025 Feb 13;16:1526524. doi: 10.3389/fneur.2025.1526524. eCollection 2025.
Intracerebral hemorrhage (ICH), a severe subtype of hemorrhagic stroke, is associated with significant disability and high mortality rates. Due to population aging and the prevalence of hypertension in the Asian region, intracerebral hemorrhage has become one of the major causes of high disability and mortality. This study analyzes the epidemiological patterns of ICH across Asia from 1990 to 2021 and projects potential trends for the period 2022 to 2041.
This study extracted four key indicators related to intracerebral hemorrhage (ICH) from The Global Burden of Disease (GBD) 2021 database for the years 1990 to 2021: prevalence, incidence, mortality, and disability-adjusted life years (DALYs). The age-period-cohort model was employed to assess the impact of age, time periods, and birth cohorts on ICH trends. Additionally, the autoregressive integrated moving average (ARIMA) model was utilized to conduct long-term trend analysis and forecast the changing trends of various indicators from 2022 to 2041.
From 1990 to 2021, age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year rate (ASDR) of ICH in Asia exhibited an overall declining trend, the ASIR declined from 82.35 per 100,000 (95% UI: 70.73-93.35) to 52.35 per 100,000 (95% UI: 45.98-58.46). Similarly, the ASMR dropped from 92.02 per 100,000 (95% UI: 83.06-101.24) to 53.26 per 100,000 (95% UI: 47.61-58.96), while the ASDR fell from 2,094.51 per 100,000 (95% UI: 1,916.68-2,293.61) to 1,194.11 per 100,000 (95% UI: 1,072.05-1,306.04). The age effect demonstrated that the relative risk (RR) of ICH increases with age, peaking in the 90-94 age group. The period effect indicated that the risk did not increase over time, while the cohort effect suggested a declining trend in later-born cohorts. The ARIMA model's predictions indicate that over the next 20 years, the age-standardized rates in Asia, except for prevalence, will generally show a declining trend.
The disease burden of ICH in Asia varies by gender and age group. According to ARIMA model predictions, while the overall burden of ICH is expected to decline over the next 20 years, the age-standardized prevalence rate is projected to increase due to population aging. Given the high mortality and disability rates associated with ICH, its disease burden remains significant and requires focused attention. Strengthening screening and hypertension management in high-risk elderly populations, along with community health education and early intervention, is recommended to reduce the risk of ICH.
脑出血（ICH）是出血性卒中的一种严重亚型，与严重残疾和高死亡率相关。由于亚洲地区人口老龄化和高血压患病率较高，脑出血已成为导致高残疾率和高死亡率的主要原因之一。本研究分析了1990年至2021年亚洲地区脑出血的流行病学模式，并预测了2022年至2041年的潜在趋势。
本研究从《全球疾病负担（GBD）2021》数据库中提取了1990年至2021年与脑出血（ICH）相关的四个关键指标：患病率、发病率、死亡率和伤残调整生命年（DALYs）。采用年龄-时期-队列模型评估年龄、时期和出生队列对脑出血趋势的影响。此外，利用自回归积分移动平均（ARIMA）模型进行长期趋势分析，并预测2022年至2041年各项指标的变化趋势。
1990年至2021年，亚洲地区脑出血的年龄标准化发病率（ASIR）、年龄标准化死亡率（ASMR）和年龄标准化伤残调整生命年率（ASDR）总体呈下降趋势，ASIR从每10万人82.35例（95% UI：70.73-93.35）降至每10万人52.35例（95% UI：45.98-58.46）。同样，ASMR从每10万人92.02例（95% UI：83.06-101.24）降至每10万人53.26例（95% UI：47.61-58.96），而ASDR从每10万人2094.51例（95% UI：1916.68-2293.61）降至每10万人1194.11例（95% UI：1072.05-1306.04）。年龄效应表明，脑出血的相对风险（RR）随年龄增长而增加，在90-94岁年龄组达到峰值。时期效应表明风险并未随时间增加，而队列效应表明晚出生队列呈下降趋势。ARIMA模型预测表明，在未来20年里，亚洲地区除患病率外的年龄标准化率总体将呈下降趋势。
亚洲地区脑出血的疾病负担因性别和年龄组而异。根据ARIMA模型预测，虽然预计未来20年脑出血的总体负担将下降，但由于人口老龄化，年龄标准化患病率预计将上升。鉴于脑出血相关的高死亡率和高残疾率，其疾病负担仍然很重，需要重点关注。建议加强对高危老年人群的筛查和高血压管理，同时开展社区健康教育和早期干预，以降低脑出血风险。
