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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

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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