Abstract
Objective: Stroke is a leading cause of mortality and morbidity globally. This study aimed to analyze the burden and 30-year trends of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in China.Methods: Data that include incidence and mortality of stroke in China from January 1, 1990 to December 31, 2019 were derived from the Global Burden of Disease (GBD) study 2019. The absolute numbers of incident cases and deaths over the time, and age-standardized rates per 100,000, such as age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR), were analyzed.Results: In 2019, there were 3.9 (95% uncertainty intervals (UI) 3.4–4.5) million incident cases and 2.1 (3.4–4.5) million deaths related to stroke in China. The ASIR and ASMR of stroke in China was 200 (176–230) and 127 (110–144). From 1990 to 2019, the ASIR of ischemic stroke had increased by 35.0% (29.0–40.0) while the ASIR of ICH and SAH had decreased by −53.0% (−56.0 to −50.0) and by −39.0% (−44.0 to −35.0), respectively. The ASMR of ischemic stroke had increased by 3.0% (−26.0 to 16.0) while the ASMR of ICH and SAH had decreased by −48.0% (−59.0 to −38.0) and by −84.0% (−89.0 to −69.0), respectively.Conclusion: Although the incidence and mortality rates of stroke in China were decreased from 1990 to 2019, the number of incident cases and deaths nearly doubled. A sharp increase in the incidence rate of ischemic stroke was observed. A higher incidence rate of ischemic stroke in the women was also observed.
Highlights
Stroke is a predominant cause of mortality and morbidity globally [1]
We aimed to provide the first systematic analysis of the trends in the incidence and mortality of the strokes, such as ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in China based on the most recent Global Burden of Diseases (GBD) study 2019
The overall incidence of stroke was estimated utilizing a Bayesian meta-regression model (DisMod-MR 2.1) and the standard Cause of Death Ensemble modeling (CODEm) method was utilized to determine the estimates of mortality [12]
Summary
In the past few decades, the incident cases of stroke continued to increase leading to a high disease burden, in the developing and low-income countries [2, 3]. The results from the previous Global Burden of Diseases (GBD) study suggested that the age-standardized incidence and mortality rates decreased but the overall burden of stroke remained high [4, 5]. As the biggest developing countries worldwide, had the largest number of incident cases and deaths related to stroke [6]. In this light, a comprehensive analysis of the stroke-related burden in Chi]na, will provide evidence to the policymakers and healthcare workers, and implement the effective prevention strategies [7].
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