2019冠状病毒病大流行对卒中负担在全球、区域和国家层面的影响和预测：对《2021年全球疾病负担研究》的综合分析

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-04-14 DOI:10.1016/j.jstrokecerebrovasdis.2025.108320

Zijing Gao MD , Rafeq Agila MD , Chao You MD, Songping Zheng MD

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引用次数: 0

摘要

本研究旨在评估2019冠状病毒病大流行在全球、区域和国家层面对卒中负担的影响和预测。方法采用标准化GBD方法，对1990年至2019年、2019年至2021年和1990年至2021年期间204个国家和地区与卒中相关的患病率、发病率、死亡率和残疾调整生命年（DALYs）进行了全面分析。我们的研究提供了详细的估计，并附有相应的95%不确定性区间（ui），按年龄和性别分层。为了阐明脑卒中负担的时间趋势，我们计算了估计年百分比变化（EAPC）。此外，我们还探讨了卒中负担与社会人口指数（SDI）水平之间的关系。分析了各种危险因素导致的脑卒中DALYs。预测了未来20年的中风负担。结果百分比变化分析和EAPC分析显示，2019 - 2021年，卒中的年龄标准化患病率（ASPR）、发病率（ASIR）、死亡率（ASMR）和DALYs率保持稳定，与1990 - 2019年和1990 - 2021年在全球、地区和国家层面观察到的下降趋势不同。这种模式同样反映在脑出血（ICH）、蛛网膜下腔出血（SAH）和缺血性中风（IS）的全球负担中。从2019年到2021年，卒中、脑出血和IS负担的变化在男性和女性之间是一致的。重要的是，无论SDI如何变化，COVID-19对卒中负担的影响仍然很大。IS负担在未来20年有所增加，应更多地关注年轻人的卒中负担。结论在2019冠状病毒病大流行期间，卒中负担呈现稳定趋势，与1990 - 2019年和1990 - 2021年的下降趋势相反。在接下来的20年里，IS和年轻人的负担增加了。这些观察结果强调了存在于不同社会经济发展水平的卒中负担差异。本研究中提供的纵向流行病学数据为COVID-19大流行带来的重大变化提供了宝贵的见解，为研究人员、政策制定者、医疗保健专业人员和其他利益攸关方提供了重要信息。

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The impact and projection of the COVID-19 pandemic on the burden of stroke at global, regional, and national levels: A comprehensive analysis for the Global Burden of Disease Study 2021

Background

We aim to estimate impact and projection of the COVID-19 pandemic on the burden of stroke at global, regional, and national levels

Methods

Utilizing standardized GBD methodologies, we conducted a comprehensive analysis of the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) associated with stroke across 204 countries and regions spanning the periods from 1990 to 2019, 2019 to 2021, and 1990 to 2021. Our study provides detailed estimates accompanied by corresponding 95% uncertainty intervals (UIs), stratified by age and sex. To elucidate the temporal trends in stroke burden, we calculated the Estimated Annual Percentage Change (EAPC). Additionally, we explored the relationship between stroke burden and sociodemographic index (SDI) levels. The DALYs attributable to various risk factors for stroke were also analyzed. The burden of stroke in the next 20 years was also predicted.

Results

From 2019 to 2021, the age-standardized prevalence rates (ASPR), incidence rates (ASIR), mortality rates (ASMR), and DALYs rates for stroke remained stable, diverging from the declining trends observed from 1990 to 2019 and from 1990 to 2021 at global, regional, and national levels, as indicated by both percent change analysis and EAPC analysis. This pattern was similarly reflected in the global burden of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and ischemic stroke (IS). The changes in the burden of stroke, ICH, and IS from 2019 to 2021 were consistent between males and females. Importantly, the impact of COVID-19 on stroke burden remains substantial, irrespective of variations in the SDI. The IS burden increased in the next 20 years, and more attention should be paid on the stroke burden in young people.

Conclusions

Throughout the COVID-19 pandemic, the burden of stroke exhibited a stable trajectory, in contrast to the declining trend observed from 1990 to 2019 and from 1990 to 2021. The increased burden was observed in IS and young people in the next 20 years. These observations highlight the disparities in stroke burden that exist across different levels of socioeconomic development. The longitudinal epidemiological data presented in this study provide valuable insights into the significant shifts brought about by the COVID-19 pandemic, offering crucial information for researchers, policymakers, healthcare professionals, and other stakeholders.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.