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Global, Regional, and National Burden of Stroke, 1990–2016: A Systematic Analysis for the Global Burden of Disease Study 2016 Publisher Pubmed



Johnson CO1 ; Nguyen M1 ; Roth GA1, 4 ; Nichols E1 ; Alam T1 ; Abate D6 ; Abdallah F7 ; Abdelalim A7 ; Abraha HN8 ; Aburmeileh NM14 ; Adebayo OM15 ; Adeoye AM16, 18 ; Agarwal G19 ; Agrawal S22, 23 Show All Authors
Authors
  1. Johnson CO1
  2. Nguyen M1
  3. Roth GA1, 4
  4. Nichols E1
  5. Alam T1
  6. Abate D6
  7. Abdallah F7
  8. Abdelalim A7
  9. Abraha HN8
  10. Aburmeileh NM14
  11. Adebayo OM15
  12. Adeoye AM16, 18
  13. Agarwal G19
  14. Agrawal S22, 23
  15. Aichour AN24
  16. Aichour I24
  17. Aichour MTE25
  18. Alahdab F26
  19. Ali R27, 28
  20. Alvisguzman N30, 31
  21. Anber NH32
  22. Anjomshoa M34, 35
  23. Arabloo J48
  24. Arauz A51
  25. Arnlov J52, 54
  26. Arora A55, 58
  27. Awasthi A22, 59
  28. Banach M60, 61
  29. Barboza MA62, 63
  30. Barkercollo SL64
  31. Barnighausen TW67, 68
  32. Basu S71
  33. Belachew AB9
  34. Belayneh YM72
  35. Bennett DA28
  36. Bensenor IM75
  37. Bhattacharyya K79
  38. Biadgo B80
  39. Bijani A81
  40. Bikbov B84
  41. Bin Sayeed MS87, 88
  42. Butt ZA89, 90
  43. Cahuanahurtado L91
  44. Carrero JJ53
  45. Carvalho F93, 96
  46. Castanedaorjuela CA97, 98
  47. Castro F99
  48. Catalalopez F101
  49. Chaiah Y102
  50. Chiang PPC103
  51. Choi JYJ104
  52. Christensen H105
  53. Chu DT107, 108
  54. Cortinovis M85
  55. Damasceno AAM109
  56. Dandona L1, 22
  57. Dandona R1, 22
  58. Daryani A110
  59. Davletov K115
  60. De Courten B116, 120
  61. De La Cruzgongora V92
  62. Degefa MG10
  63. Dharmaratne SD1, 121
  64. Diaz D122, 123
  65. Dubey M124
  66. Duken EE125, 126
  67. Edessa D5
  68. Endres M127
  69. Faraon EJA128, 129
  70. Farzadfar F36
  71. Fernandes E94
  72. Fischer F130
  73. Flor LS131, 132
  74. Ganji M37
  75. Gebre AK11
  76. Gebremichael TG11
  77. Geta B73
  78. Gezae KE12
  79. Gill PS133
  80. Gnedovskaya EV135
  81. Gomezdantes H91
  82. Goulart AC76, 78
  83. Grosso G136
  84. Guo Y117
  85. Gupta R137, 138
  86. Hajmirzaian A38
  87. Hajmirzaian A38
  88. Hamidi S146
  89. Hankey GJ147, 148
  90. Hassen HY149, 151
  91. Hay SI1, 2
  92. Hegazy MI7
  93. Heidari B152
  94. Herial NA153
  95. Hosseini MA154
  96. Hostiuc S155, 157
  97. Irvani SSN36, 139
  98. Islam SMS158, 160
  99. Jahanmehr N140, 143
  100. Javanbakht M161
  101. Jha RP162
  102. Jonas JB163, 164
  103. Jozwiak JJ165, 166
  104. Jurisson M167
  105. Kahsay A10
  106. Kalani R3
  107. Kalkonde Y168
  108. Kamil TA169
  109. Kanchan T171
  110. Karch A172
  111. Karimi N111, 113
  112. Karimisari H173, 174
  113. Kasaeian A39, 44
  114. Kassa TD8
  115. Kazemeini H175
  116. Kefale AT150
  117. Khader YS176
  118. Khalil IA1, 2
  119. Khan EA177
  120. Khang YH178, 179
  121. Khubchandani J180
  122. Kim D181
  123. Kim YJ182
  124. Kisa A183, 184
  125. Kivimaki M185, 186
  126. Koyanagi A188
  127. Krishnamurthi RK190
  128. Anil Kumar G22
  129. Lafranconi A189
  130. Lewington S28
  131. Li S117
  132. Lo WD193, 194
  133. Lopez AD1, 197
  134. Lorkowski S198, 199
  135. Lotufo PA77
  136. Mackay MT195, 200
  137. Majdan M201
  138. Majdzadeh R40, 45
  139. Majeed A202
  140. Malekzadeh R41, 203
  141. Manafi N204, 205
  142. Mansournia MA42
  143. Mehndiratta MM206
  144. Mehta V207
  145. Mengistu G5, 74
  146. Meretoja A196, 208
  147. Meretoja TJ187, 209
  148. Miazgowski B211
  149. Miazgowski T210
  150. Miller TR213, 214
  151. Mirrakhimov EM215, 216
  152. Mohajer B36, 46
  153. Mohammad Y217
  154. Mohammadookhorasani M219
  155. Mohammed S164, 220
  156. Mohebi F36, 47
  157. Mokdad AH1, 2
  158. Moradi G221, 222
  159. Morawska L223
  160. Moreno Velasquez I100
  161. Mousavi SM35
  162. Muhammed OSS224
  163. Muruet W225
  164. Naderi M227
  165. Naghavi M1, 2
  166. Naik G230
  167. Nascimento BR232
  168. Negoi RI156, 233
  169. Nguyen CT234
  170. Nguyen LH235
  171. Nirayo YL8
  172. Norrving B236
  173. Noubiap JJ237
  174. Oforiasenso R118, 238
  175. Ogbo FA57
  176. Olagunju AT239, 240
  177. Olagunju TO20
  178. Owolabi MO17
  179. Pandian JD241
  180. Patel S242
  181. Perico N84
  182. Piradov MA135
  183. Polinder S243
  184. Postma MJ244, 245
  185. Poustchi H41
  186. Prakash V246
  187. Qorbani M247
  188. Rafiei A112, 114
  189. Rahim F248
  190. Rahimi K29
  191. Rahimimovaghar V43
  192. Rahman M159
  193. Rahman MA251, 253
  194. Reis C254
  195. Remuzzi G86
  196. Renzaho AMN56
  197. Ricci S255
  198. Roberts NLS1
  199. Robinson SR256
  200. Roever L257
  201. Roshandel G41, 258
  202. Sabbagh P82
  203. Safari H249
  204. Safari S141
  205. Safiri S259
  206. Sahebkar A260, 261
  207. Salehi Zahabi S228, 262
  208. Samy AM263
  209. Santalucia P264
  210. Santos IS75
  211. Santos JV95, 265
  212. Santric Milicevic MM266
  213. Sartorius B267
  214. Sawant AR231, 268
  215. Schutte AE269, 270
  216. Sepanlou SG41, 203
  217. Shafieesabet A271
  218. Shaikh MA272
  219. Shamsbeyranvand M36, 273
  220. Sheikh A69, 274
  221. Sheth KN275
  222. Shibuya K276
  223. Shigematsu M278
  224. Shin MJ279
  225. Shiue I280
  226. Siabani S229, 281
  227. Sobaih BH218, 282
  228. Sposato LA283
  229. Sutradhar I252
  230. Sylaja PA284
  231. Szoeke CEI196, 286
  232. Te Ao BJ65, 191, 192
  233. Temsah MH102, 218
  234. Temsah O102
  235. Thrift AG119
  236. Tonelli M287
  237. Topormadry R288, 289
  238. Tran BX290
  239. Tran KB66, 291
  240. Truelsen TC106
  241. Tsadik AG11
  242. Ullah I292, 293
  243. Uthman OA134
  244. Vaduganathan M70
  245. Valdez PR294, 295
  246. Vasankari TJ296
  247. Vasanthan R297
  248. Venketasubramanian N298, 299
  249. Vosoughi K49, 145
  250. Vu GT235
  251. Waheed Y300
  252. Weiderpass E53, 301
  253. Weldegwergs KG8
  254. Westerman R302
  255. Wolfe CDA226, 303
  256. Wondafrash DZ13
  257. Xu G304
  258. Yadollahpour A250
  259. Yamada T277
  260. Yatsuya H305, 306
  261. Yimer EM11
  262. Yonemoto N307
  263. Yousefifard M50
  264. Yu C308, 310
  265. Zaidi Z170
  266. Zamani M83
  267. Zarghi A142
  268. Zhang Y309
  269. Zodpey S21
  270. Feigin VL1, 191, 192
  271. Vos T1, 2
  272. Murray CJL1, 2
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  2. 2. Department of Health Metrics Sciences, University of Washington, Seattle, WA, United States
  3. 3. Department of Neurology, University of Washington, Seattle, WA, United States
  4. 4. Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, United States
  5. 5. School of Pharmacy, Haramaya University, Harar, Ethiopia
  6. 6. Haramaya University, Harar, Ethiopia
  7. 7. Department of Neurology, Cairo University, Cairo, Egypt
  8. 8. Clinical Pharmacy Unit, Mekelle University, Mekelle, Ethiopia
  9. 9. School of Public Health, Mekelle University, Mekelle, Ethiopia
  10. 10. Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
  11. 11. School of Pharmacy, Mekelle University, Mekelle, Ethiopia
  12. 12. Department of Biostatistics, Mekelle University, Mekelle, Ethiopia
  13. 13. Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
  14. 14. Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
  15. 15. Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
  16. 16. Department of Medicine, University of Ibadan, Ibadan, Nigeria
  17. 17. Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
  18. 18. Community Cardiovascular Research Unit, Ibadan, Nigeria
  19. 19. Department of Family Medicine, McMaster University, Hamilton, ON, Canada
  20. 20. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
  21. 21. Indian Institute of Public Health, Gurugram, India
  22. 22. Public Health Foundation of India, Gurugram, India
  23. 23. Vital Strategies, Gurugram, India
  24. 24. University Ferhat Abbas of Setif, Algeria
  25. 25. Higher National School of Veterinary Medicine, Algiers, Algeria
  26. 26. Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  27. 27. Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
  28. 28. Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  29. 29. Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
  30. 30. Research Group on Health Economics, University of Cartagena, Cartagena, Colombia
  31. 31. Research Group on Hospital Management and Health Policies, University of the Coast, Barranquilla, Colombia
  32. 32. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  33. 33. Mansoura University, Mansoura, Egypt
  34. 34. Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  35. 35. Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
  36. 36. Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  37. 37. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  38. 38. Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
  39. 39. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  40. 40. Community-Based Participatory-Research Center (CBPR), Tehran University of Medical Sciences, Tehran, Iran
  41. 41. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  42. 42. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
  43. 43. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  44. 44. Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
  45. 45. Knowledge Utilization Research Center (kur), Tehran University of Medical Sciences, Tehran, Iran
  46. 46. Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
  47. 47. Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
  48. 48. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  49. 49. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  50. 50. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
  51. 51. Stroke Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
  52. 52. Department of Neurobiology, Karolinska Institutet, Stockholm, Sweden
  53. 53. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  54. 54. School of Health and Social Studies, Dalarna University, Falun, Sweden
  55. 55. School of Science and Health, Western Sydney University, Sydney, NSW, Australia
  56. 56. School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia
  57. 57. Western Sydney University, Sydney, NSW, Australia
  58. 58. Oral Health Services, Sydney Local Health District, Sydney, NSW, Australia
  59. 59. Indian Institute of Public Health, Gandhinagar, India
  60. 60. Department of Hypertension, Medical University of Lodz, Lodz, Poland
  61. 61. Polish Mothers’ Memorial Hospital Research Institute, Lodz, Poland
  62. 62. Department of Neurosciences, Costa Rican Department of Social Security, San Jose, Costa Rica
  63. 63. School of Medicine, University of Costa Rica, San Pedro, Costa Rica
  64. 64. School of Psychology, University of Auckland, Auckland, New Zealand
  65. 65. School of Population Health, Faculty of Medical & Health Science, University of Auckland, Auckland, New Zealand
  66. 66. Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
  67. 67. Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany
  68. 68. T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  69. 69. Division of General Internal Medicine and Primary Care, Harvard University, Boston, MA, United States
  70. 70. Heart and Vascular Center, Harvard University, Boston, MA, United States
  71. 71. Department of Medicine, Stanford University, Palo Alto, CA, United States
  72. 72. Pharmacy Department, Wollo University, Dessie, Ethiopia
  73. 73. Pharmacy, Wollo University, Dessie, Ethiopia
  74. 74. Department of Pharmacy, Wollo University, Dessie, Ethiopia
  75. 75. Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil
  76. 76. University Hospital, Internal Medicine Department, University of Sao Paulo, Sao Paulo, Brazil
  77. 77. Department of Medicine, University of Sao Paulo, Sao Paulo, Brazil
  78. 78. Center for Clinical and Epidemiological Research, University of Sao Paulo, Sao Paulo, Brazil
  79. 79. Biostatistics and Bioinformatics, National Institute of Biomedical Genomics, Kalyani, India
  80. 80. Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
  81. 81. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  82. 82. Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
  83. 83. Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  84. 84. Department of Renal Medicine, Mario Negri Institute for Pharmacological Research, Ranica, Italy
  85. 85. Department of Oncology, Mario Negri Institute for Pharmacological Research, Ranica, Italy
  86. 86. Mario Negri Institute for Pharmacological Research, Ranica, Italy
  87. 87. National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
  88. 88. Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Ramna, Bangladesh
  89. 89. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  90. 90. Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  91. 91. Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
  92. 92. Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico
  93. 93. Institute of Public Health, University of Porto, Porto, Portugal
  94. 94. REQUIMTE/LAQV, University of Porto, Porto, Portugal
  95. 95. Department of Community Medicine, University of Porto, Porto, Portugal
  96. 96. Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
  97. 97. Colombian National Health Observatory, National Institute of Health, Bogota, Colombia
  98. 98. Epidemiology and Public Health Evaluation Group, National University of Colombia, Bogota, Colombia
  99. 99. Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City, Panama
  100. 100. Gorgas Memorial Institute for Health Studies, Panama City, Panama
  101. 101. Department of Health Planning and Economics, Institute of Health Carlos Iii, Madrid, Spain
  102. 102. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  103. 103. Clinical Governance, Gold Coast Health, Gold Coast, QLD, Australia
  104. 104. Biochemistry, Biomedical Science, Seoul National University Hospital, Seoul, South Korea
  105. 105. Institute of Clinical Medicine and Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  106. 106. Department of Neurology, University of Copenhagen, Copenhagen, Denmark
  107. 107. Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam
  108. 108. Department of Cancer Immunology, Institute of Cancer Research, Oslo University Hospital, Oslo, Norway
  109. 109. Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
  110. 110. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  111. 111. Department of Neurology, Mazandaran University of Medical Sciences, Sari, Iran
  112. 112. Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  113. 113. Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  114. 114. Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
  115. 115. Kazakh National Medical University, Almaty, Kazakhstan
  116. 116. Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia
  117. 117. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  118. 118. Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, VIC, Australia
  119. 119. Monash University, Melbourne, VIC, Australia
  120. 120. Department of Diabetes and Vascular Medicine, Monash Health, Melbourne, VIC, Australia
  121. 121. Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  122. 122. Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
  123. 123. Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacan Rosales, Mexico
  124. 124. United Nations World Food Programme, New Delhi, India
  125. 125. Department of Health Sciences, Wollega University, Nekemte, Ethiopia
  126. 126. Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
  127. 127. Department of Neurology, Charite University Medical Center Berlin, Berlin, Germany
  128. 128. Medical Informatics Unit, College of Medicine, University of the Philippines Manila, Manila, Philippines
  129. 129. Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
  130. 130. Department of Public Health Medicine, Bielefeld University, Bielefeld, Germany
  131. 131. Sergio Arouca National School of Public Health, Rio De Janeiro, Brazil
  132. 132. Federal University of Espirito Santo, Vitoria, Brazil
  133. 133. Unit of Academic Primary Care, University of Warwick, Coventry, United Kingdom
  134. 134. Division of Health Sciences, University of Warwick, Coventry, United Kingdom
  135. 135. Research Center of Neurology, Moscow, Russian Federation
  136. 136. Registro Tumori Integrato, Vittorio Emanuele University Hospital Polyclinic, Catania, Italy
  137. 137. Academics and Research, Rajasthan University of Health Sciences, Jaipur, India
  138. 138. Department of Preventive Cardiology, Eternal Heart Care Centre & Research Institute, Jaipur, India
  139. 139. Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  140. 140. School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  141. 141. Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  142. 142. Department of Medicinal and Pharmaceutical Chemistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  143. 143. Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  144. 144. Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
  145. 145. Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, United States
  146. 146. School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  147. 147. School of Medicine, University of Western Australia, Perth, WA, Australia
  148. 148. Neurology Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
  149. 149. Public Health Department, Mizan-Tepi University, Teppi, Ethiopia
  150. 150. Pharmacy Department, Mizan-Tepi University, Teppi, Ethiopia
  151. 151. Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
  152. 152. Endocrinology and Metabolism Research Center, Teikyo University School of Medicine, Tehran, Iran
  153. 153. Department of Neurology, Thomas Jefferson University, Philadelphia, PA, United States
  154. 154. Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
  155. 155. Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  156. 156. Anatomy and Embryology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  157. 157. Clinical Legal Medicine, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
  158. 158. Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
  159. 159. School of Medicine, Deakin University, Burwood, VIC, Australia
  160. 160. Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  161. 161. Newcastle University, Tyne, United Kingdom
  162. 162. Department of Community Medicine, Banaras Hindu University, Varanasi, India
  163. 163. Department of Ophthalmology, Heidelberg University, Mannheim, Germany
  164. 164. Institute of Public Health, Heidelberg University, Mannheim, Germany
  165. 165. Faculty of Medicine and Health Sciences, University of Opole, Opole, Poland
  166. 166. Department of Family Medicine and Public Health, University of Opole, Opole, Poland
  167. 167. Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  168. 168. Public Health, Society for Education, Action and Research in Community Health, India
  169. 169. School of Public Health, Department of Health Informatics and Health Innovation, A.C.S. Medical College and Hospital, Mekelle, Ethiopia
  170. 170. A.C.S. Medical College and Hospital, Mekelle, Ethiopia
  171. 171. Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
  172. 172. Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
  173. 173. Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
  174. 174. Department of Young Investigators, Middle East Liver Disease Center, Tehran, Iran
  175. 175. Ministry of Health and Medical Education, Tehran, Iran
  176. 176. Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan
  177. 177. Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
  178. 178. Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
  179. 179. Department of Health Policy and Management, Seoul National University, Seoul, South Korea
  180. 180. Department of Nutrition and Health Science, Ball State University, Muncie, IN, United States
  181. 181. Department of Health Sciences, Northeastern University, Boston, MA, United States
  182. 182. School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
  183. 183. Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
  184. 184. Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, United States
  185. 185. Department of Epidemiology and Public Health, University College London, London, United Kingdom
  186. 186. Department of Public Health, University of Helsinki, Helsinki, Finland
  187. 187. University of Helsinki, Helsinki, Finland
  188. 188. Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi De Llobregat, Spain
  189. 189. School of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
  190. 190. School of Public Health, Auckland University of Technology, Auckland, New Zealand
  191. 191. National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
  192. 192. National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
  193. 193. Department of Pediatrics, Ohio State University, Columbus, OH, United States
  194. 194. Department of Pediatric Neurology, Nationwide Children’s Hospital, Columbus, OH, United States
  195. 195. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
  196. 196. School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia
  197. 197. University of Melbourne, Melbourne, VIC, Australia
  198. 198. Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany
  199. 199. Competence Cluster for Nutrition and Cardiovascular Health (NUTRICARD), Jena, Germany
  200. 200. Neurology Department, Royal Children’s Hospital, Melbourne, VIC, Australia
  201. 201. Department of Public Health, Trnava University, Trnava, Slovakia
  202. 202. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  203. 203. Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  204. 204. Ophthalmology, IUMS, Tehran, Iran
  205. 205. Ophthalmology, University of Manitoba, Winnipeg, MB, Canada
  206. 206. Neurology Department, Janakpuri Super Specialty Hospital Society, New Delhi, India
  207. 207. Department of Internal Medicine, Sevenhills Hospital, Mumbai, India
  208. 208. Neurocenter, Helsinki University Hospital, Helsinki, Finland
  209. 209. Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
  210. 210. Department of Hypertension, Pomeranian Medical University, Szczecin, Poland
  211. 211. Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
  212. 212. Pomeranian Medical University, Szczecin, Poland
  213. 213. Pacific Institute for Research & Evaluation, Calverton, MD, United States
  214. 214. School of Public Health, Curtin University, Perth, WA, Australia
  215. 215. Faculty of General Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  216. 216. Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  217. 217. Internal Medicine, King Saud University, Riyadh, Saudi Arabia
  218. 218. Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
  219. 219. Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
  220. 220. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  221. 221. Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
  222. 222. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  223. 223. International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
  224. 224. Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
  225. 225. School of Population Health and Environmental Sciences, King’s College London, London, United Kingdom
  226. 226. School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
  227. 227. Department of Operating Room, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran
  228. 228. Radiology and Nuclear Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  229. 229. Imam Ali Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  230. 230. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
  231. 231. University of Alabama at Birmingham, Birmingham, AL, United States
  232. 232. Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil
  233. 233. Department of Cardiology, Cardio-Aid, Bucharest, Romania
  234. 234. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  235. 235. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  236. 236. Department of Clinical Sciences, Lund University, Lund, Sweden
  237. 237. Department of Medicine, University of Cape Town, Cape Town, South Africa
  238. 238. Independent Consultant, Accra, Ghana
  239. 239. University of Adelaide, Adelaide, SA, Australia
  240. 240. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  241. 241. Department of Neurology, Christian Medical College and Hospital (CMC), Ludhiana, India
  242. 242. Department of Medicine, Maimonides Medical Center, Brooklyn, NY, United States
  243. 243. Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
  244. 244. Department of Economics and Business, University of Groningen, Groningen, Netherlands
  245. 245. University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  246. 246. Askok & Rita Patel Institute of Physiotherapy, Charotar University of Science and Technology, Anand, India
  247. 247. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  248. 248. Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  249. 249. Department of Neurosurgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  250. 250. Medical Physics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  251. 251. Research and Evaluation Division, Brac University, Dhaka, Bangladesh
  252. 252. James P Grant School of Public Health, Brac University, Dhaka, Bangladesh
  253. 253. Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
  254. 254. Department of Preventive Medicine and Occupational Medicine, Loma Linda University Medical Center, Loma Linda, CA, United States
  255. 255. UO Neurologia, USL Umbria 1, Citta Di Castello, Italy
  256. 256. Department of Psychology, Royal Melbourne Institute of Technology University, Bundoora, VIC, Australia
  257. 257. Department of Clinical Research, Federal University of Uberlandia, Uberlandia, Brazil
  258. 258. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  259. 259. Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
  260. 260. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  261. 261. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  262. 262. Research Deputy, Taleghani Hospital, Kermanshah, Iran
  263. 263. Department of Entomology, Ain Shams University, Cairo, Egypt
  264. 264. Department of Neurology, IRCCS Neurolesi Center “Bonino Pulejo-Piemonte� Hospital, Messina, Italy
  265. 265. Department of Public Health, Regional Health Administration Do Norte I.P., Vila Nova De Gaia, Portugal
  266. 266. Centre School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
  267. 267. Department of Public Health Medicine, University of Kwazulu-Natal, Durban, South Africa
  268. 268. Dr. D.Y. Patil Vidyapeeth, Pune, India
  269. 269. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
  270. 270. Unit for Hypertension and Cardiovascular Disease, South African Medical Research Council, Cape Town, South Africa
  271. 271. Langone Medical Center, New York University, New York, NY, United States
  272. 272. Independent Consultant, Karachi, Pakistan
  273. 273. School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
  274. 274. Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
  275. 275. Department of Neurology, Yale University, New Haven, CT, United States
  276. 276. Department of Global Health Policy, University of Tokyo, Bunkyo-Ku, Japan
  277. 277. Department of Diabetes and Metabolic Diseases, University of Tokyo, Bunkyo-Ku, Japan
  278. 278. National Institute of Infectious Diseases, Tokyo, Japan
  279. 279. Korea University, Seoul, South Korea
  280. 280. Institute of Medical Epidemiology, Martin Luther University Halle-Wittenberg, Halle, Germany
  281. 281. School of Health, University of Technology Sydney, Sydney, NSW, Australia
  282. 282. Pediatric Department, King Khalid University Hospital, Riyadh, Saudi Arabia
  283. 283. Clinical Neurological Sciences, The University of Western Ontario, London, ON, Canada
  284. 284. Neurology Department, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  285. 285. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  286. 286. The Brain Institute, Australian Catholic University, National, Australia
  287. 287. Department of Medicine, University of Calgary, Calgary, AB, Canada
  288. 288. Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
  289. 289. Agency for Health Technology Assessment and Tariff System, Warszawa, Poland
  290. 290. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  291. 291. Clinical Hematology and Toxicology, Military Medical University, Hanoi, Viet Nam
  292. 292. Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
  293. 293. TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
  294. 294. Argentine Society of Medicine, Ciudad De Buenos Aires, Argentina
  295. 295. Velez Sarsfield Hospital, Buenos Aires, Argentina
  296. 296. UKK Institute, Tampere, Finland
  297. 297. Department of Neurophysiotherapy, The Oxford College of Physiotherapy, Bangalore, India
  298. 298. Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
  299. 299. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  300. 300. Foundation University Medical College, Foundation University, Rawalpindi, Pakistan
  301. 301. Department of Research, Cancer Registry of Norway, Oslo, Norway
  302. 302. Competence Center Mortality-Follow-Up, Federal Institute for Population Research, Wiesbaden, Germany
  303. 303. Biomedical Research Council, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
  304. 304. School of Medicine, Nanjing University, Nanjing, China
  305. 305. Department of Public Health, Fujita Health University, Toyoake, Japan
  306. 306. Department of Public Health and Health Systems, Nagoya University, Nagoya, Japan
  307. 307. Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
  308. 308. Global Health Institute, Wuhan University, Wuhan, China
  309. 309. Department of Preventive Medicine, Wuhan University, Wuhan, China
  310. 310. Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China

Source: The Lancet Neurology Published:2019


Abstract

Background: Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. Methods: We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. Findings: In 2016, there were 5·5 million (95% UI 5·3 to 5·7) deaths and 116·4 million (111·4 to 121·4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36·2% (−39·3 to −33·6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34·2% (−37·2 to −31·5), also with decreases in all SDI quintiles. There were 13·7 million (12·7 to 14·7) new stroke cases in 2016. Global age-standardised incidence declined by 8·1% (−10·7 to −5·5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80·1 million (74·1 to 86·3) prevalent cases of stroke globally in 2016; 41·1 million (38·0 to 44·3) in women and 39·0 million (36·1 to 42·1) in men. Interpretation: Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor. Funding: Bill & Melinda Gates Foundation © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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