Hao Guangzhi, Han Yuwei, Liang Yong, Zhang Bingying, Dong Yushu, Liang Guobiao
Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Front Neurol. 2025 Sep 8;16:1554952. doi: 10.3389/fneur.2025.1554952. eCollection 2025.
This study analyzes the global, regional, and national burden of intracerebral hemorrhage (ICH) in adolescents and young adults using data from the Global Burden of Disease Study 2021. ICH in younger populations impacts cognitive and physical health, hindering educational and professional development. This research provides insights into ICH trends, burden distribution, and future projections to support targeted public health strategies.
We extracted age-standardized incidence, mortality, and disability-adjusted life years (DALYs) data for ICH from 1990 to 2021, stratified by age, sex, and Socio-demographic Index (SDI). Estimates were generated using the DisMod-MR 2.1 Bayesian meta-regression framework. Temporal trends were analyzed, and decomposition analysis was performed to quantify the contributions of population growth, aging, and epidemiological changes to the evolving ICH burden. Frontier analysis was used to evaluate the performance of countries relative to their SDI levels. Forecasts of ICH burden through 2044 were produced using the Nordpred age-period-cohort model, with internal validation and sensitivity analyses conducted to assess model robustness.
From 1990 to 2021, global age-standardized ICH incidence, DALYs, and mortality rates declined, though absolute cases, deaths, and DALYs rose in low- and middle-SDI regions. High-SDI areas showed the most substantial burden reductions, while Oceania and Sub-Saharan Africa exhibited higher rates due to limited healthcare resources. Projections suggest further declines in age-standardized DALYs and mortality, though incidence may rise by 2044.
Despite declining age-standardized rates, absolute ICH burdens continue to grow in low-SDI regions, underscoring the need for tailored public health policies and resource allocation to reduce ICH disparities in young populations, especially in underserved regions. Equitable healthcare resources and targeted interventions are essential for reducing global ICH disparities and improving outcomes.
本研究利用《2021年全球疾病负担研究》的数据，分析青少年和青年成年人脑出血（ICH）的全球、区域和国家负担。年轻人群中的脑出血会影响认知和身体健康，阻碍教育和职业发展。本研究为脑出血的趋势、负担分布及未来预测提供见解，以支持有针对性的公共卫生策略。
我们提取了1990年至2021年按年龄、性别和社会人口指数（SDI）分层的脑出血年龄标准化发病率、死亡率和伤残调整生命年（DALY）数据。估计值采用DisMod-MR 2.1贝叶斯元回归框架生成。分析了时间趋势，并进行了分解分析，以量化人口增长、老龄化和流行病学变化对不断演变的脑出血负担的贡献。采用前沿分析评估各国相对于其SDI水平的表现。利用Nordpred年龄-时期-队列模型预测了到2044年的脑出血负担，并进行了内部验证和敏感性分析以评估模型的稳健性。
1990年至2021年，全球年龄标准化脑出血发病率、DALY和死亡率有所下降，尽管在低和中等SDI地区，绝对病例数、死亡数和DALY有所上升。高SDI地区负担减轻最为显著，而大洋洲和撒哈拉以南非洲由于医疗资源有限，发病率较高。预测表明，年龄标准化DALY和死亡率将进一步下降，但到2044年发病率可能上升。
尽管年龄标准化发病率下降，但低SDI地区脑出血的绝对负担仍在继续增加，这突出表明需要制定针对性的公共卫生政策和资源分配，以减少年轻人群中脑出血的差异，特别是在服务不足的地区。公平的医疗资源和有针对性的干预措施对于减少全球脑出血差异和改善结局至关重要。
