Gu Long, Zhou Jian, Zhang Lihan, Li Chun, Bao Kunyang, Du Fengling, Jiang Nan, Peng Jianhua, Jiang Yong
Department of Neurosurgery (L.G., J.Z., L.Z., K.B., J.P., Y.J.), Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Laboratory of Neurological Diseases and Brain Function (L.G., J.Z., L.Z., N.J., J.P., Y.J.), Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Stroke. 2025 Apr;56(4):887-897. doi: 10.1161/STROKEAHA.124.048950. Epub 2025 Mar 4.
Subarachnoid hemorrhage (SAH) is a critical condition that has far-reaching implications for public health systems globally due to its severe consequences and long-term disabilities. This study aims to provide a comprehensive analysis of SAH trends from 1990 to 2021 and project future trends up to 2041, aiding in better understanding and management of its global burden.
We utilized data from the GBD (Global Burden of Disease) 2021 database, using joinpoint regression, frontier, and decomposition analyses to assess changes in SAH burden. Bayesian Age-Period-Cohort modeling was implemented to predict future trends. Our study included populations from 204 countries and territories.
From 1990 to 2021, SAH incidence decreased by -1.03% for men and -1.16% for women, while mortality rates declined by -2.56% for men and -2.69% for women. Middle sociodemographic index locations and East Asia experienced substantial declines, particularly among women. However, countries like the Philippines and Turkmenistan showed increasing trends. Population aging and growth significantly contributed to these trends, while epidemiological changes led to reductions in SAH burden. The prediction model forecasts continued decreases in SAH mortality and disability-adjusted life years over the next 20 years, although incidence rates may slightly increase.
The global burden of SAH has significantly diminished from 1990 to 2021, with considerable variations across regions, sexes, and countries. Ongoing and future research should prioritize high-risk populations and develop innovative interventions to further decrease SAH incidence and enhance outcomes.
蛛网膜下腔出血（SAH）是一种危急病症，因其严重后果和长期残疾，对全球公共卫生系统有着深远影响。本研究旨在全面分析1990年至2021年期间SAH的趋势，并预测直至2041年的未来趋势，以助于更好地理解和管理其全球负担。
我们利用了全球疾病负担（GBD）2021数据库的数据，采用连接点回归、前沿分析和分解分析来评估SAH负担的变化。实施贝叶斯年龄-时期-队列模型以预测未来趋势。我们的研究涵盖了204个国家和地区的人群。
从1990年到2021年，男性SAH发病率下降了-1.03%，女性下降了-1.16%，而男性死亡率下降了-2.56%，女性下降了-2.69%。社会人口统计学指数中等的地区和东亚地区下降显著，尤其是女性。然而，菲律宾和土库曼斯坦等国家呈现上升趋势。人口老龄化和增长对这些趋势有显著贡献，而流行病学变化导致SAH负担减轻。预测模型预测，在未来20年里，SAH死亡率和伤残调整生命年会持续下降，尽管发病率可能会略有上升。
从1990年到2021年，SAH的全球负担显著减轻，各地区、性别和国家之间存在相当大的差异。当前和未来的研究应将高风险人群作为重点，并开发创新性干预措施，以进一步降低SAH发病率并改善治疗结果。
