Time trends in subarachnoid haemorrhage mortality across the BRICS (Brazil, Russian Federation, India, China and South Africa): an age-period-cohort analysis for the GBD 2021.

OBJECTIVES

Subarachnoid haemorrhage (SAH) is the third most prevalent subtype of stroke, representing a critical and potentially life-threatening cerebrovascular emergency. Given their large populations and diverse healthcare infrastructures, the BRICS (Brazil, Russian Federation, India, China and South Africa) nations play a pivotal role in the global SAH landscape. This investigation assesses the mortality trends of SAH in BRICS countries from 1982 to 2021.

DESIGN AND PARTICIPANTS

This study uses data from the Global Burden of Disease (GBD) 2021 public dataset to investigate the temporal trends in SAH mortality over four decades globally and within BRICS countries. The age-period-cohort (APC) model was employed to estimate net drift, local drift, age-specific curves and period (cohort) relative risks.

PRIMARY OUTCOME MEASURES

Mortality.

RESULTS

From 1982 to 2021, there was a 3.85% increase in global SAH deaths and a 59.46% decrease in age-standardised mortality rates. SAH mortality rates are increasing across various age groups in BRICS countries, except in China and the Russian Federation, where most age groups show increasing trends. The annual net drift in SAH mortality varied from a decrease of 5.62% in China to an increase of 0.31% in the Russian Federation. Countries demonstrated similar age-effect patterns, with risk decreasing as age increased. However, period and cohort effects varied, suggesting different control measures and temporal mortality trends.

CONCLUSIONS

Changing patterns of mortality from SAH in the BRICS countries over the last four decades vary. We suggest using local resources to step up SAH prevention. Healthcare for all ages, especially the vulnerable, should improve to prevent and treat SAH better.