Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: Johnson, Catherine Owens; Nguyen, Minh; Roth, Gregory A; Nichols, Emma; Alam, Tahiya; Abate, Degu; Abd-Allah, Foad; Abdelalim, Ahmed; Abraha, Haftom Niguse; Abu-Rmeileh, Niveen ME; Adebayo, Oladimeji M; Adeoye, Abiodun Moshood; Agarwal, Gina; Agrawal, Sutapa; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Alahdab, Fares; Ali, Raghib; Alvis-Guzman, Nelson; Anber, Nahla Hamed; Anjomshoa, Mina; Arabloo, Jalal; Arauz, Antonio; Ärnlöv, Johan; Arora, Amit; Awasthi, Ashish; Banach, Maciej; Barboza, Miguel A; Barker-Collo, Suzanne Lyn; Bärnighausen, Till Winfried; Basu, Sanjay; Belachew, Abate Bekele; Belayneh, Yaschilal Muche; Bennett, Derrick A.; Bensenor, Isabela M; Bhattacharyya, Krittika; Biadgo, Belete; Bijani, Ali; Bikbov, Boris; Bin Sayeed, Muhammad Shahdaat; Butt, Zahid A; Cahuana-Hurtado, Lucero; Carrero, Juan J; Carvalho, Félix; Castañeda-Orjuela, Carlos A; Castro, Franz; Catalá-López, Ferrán; Chaiah, Yazan; Chiang, Peggy Pei-Chia; Choi, Jee-Young J; Christensen, Hanne; Chu, Dinh-Toi; Cortinovis, Monica; Damasceno, Albertino Antonio Moura; Dandona, Lalit; Dandona, Rakhi; Daryani, Ahmad; Davletov, Kairat; de Courten, Barbora; De la Cruz-Góngora, Vanessa; Degefa, Meaza Girma; Dharmaratne, Samath Dhamminda; Diaz, Daniel; Dubey, Manisha; Duken, Eyasu Ejeta; Edessa, Dumessa; Endres, Matthias; FARAON, EMERITO JOSE A; Farzadfar, Farshad; Fernandes, Eduarda; Fischer, Florian; Flor, Luisa Sorio; Ganji, Morsaleh; Gebre, Abadi Kahsu; Gebremichael, Teklu Gebrehiwo; Geta, Birhanu; Gezae, Kebede Embaye; Gill, Paramjit Singh; Gnedovskaya, Elena V.; Gómez-Dantés, Hector; Goulart, Alessandra C; Grosso, Giuseppe; Guo, Yuming; Gupta, Rajeev; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hamidi, Samer; Hankey, Graeme J.; Hassen, Hamid Yimam; Hay, Simon I.; Hegazy, Mohamed I; Heidari, Behnam; Herial, Nabeel A; Hosseini, Mohammad Ali; Hostiuc, Sorin; Irvani, Seyed Sina Naghibi; Islam, Sheikh Mohammed Shariful; Jahanmehr, Nader; Javanbakht, Mehdi; Jha, Ravi Prakash; Jonas, Jost B.; Jozwiak, Jacek Jerzy; Jürisson, Mikk; Kahsay, Amaha; Kalani, Rizwan; Kalkonde, Yogeshwar; Kamil, Teshome Abegaz; Kanchan, Tanuj; Karch, André; Karimi, Narges; Karimi-Sari, Hamidreza; Kasaeian, Amir; Kassa, Tesfaye Dessale; Kazemeini, Hossein; Kefale, Adane Teshome; Khader, Yousef Saleh; Khalil, Ibrahim A.; Khan, Ejaz Ahmad; Khang, Young-Ho; Khubchandani, Jagdish; Kim, Daniel; Kim, Yun Jin; Kisa, Adnan; Kivimäki, Mika; Koyanagi, Ai; Krishnamurthi, Rita K; Kumar, G Anil; Lafranconi, Alessandra; Lewington, Sarah; Li, Shanshan; Lo, Warren David; Lopez, Alan D; Lorkowski, Stefan; Lotufo, Paulo A.; Mackay, Mark T; Majdan, Marek; Majdzadeh, Reza; Majeed, Azeem; Malekzadeh, Reza; Manafi, Navid; Mansournia, Mohammad Ali; Mehndiratta, Man Mohan; Mehta, Varshil; Mengistu, Getnet; Meretoja, Atte; Meretoja, Tuomo J; Miazgowski, Bartosz; Miazgowski, Tomasz; Miller, Ted R; Mirrakhimov, Erkin M; Mohajer, Bahram; Mohammad, Yousef; Mohammadoo-khorasani, Milad; Mohammed, Shafiu; Mohebi, Farnam; Mokdad, Ali H; Mokhayeri, Yaser; Moradi, Ghobad; Morawska, Lidia; Moreno Velásquez, Ilais; Mousavi, Seyyed Meysam; Muhammed, Oumer Sada S; Muruet, Walter; Naderi, Mehdi; Naghavi, Mohsen; Naik, Gurudatta; Nascimento, Bruno Ramos; Negoi, Ruxandra Irina; Nguyen, Cuong Tat; Nguyen, Long Hoang; Nirayo, Yirga Legesse; Norrving, Bo; Noubiap, Jean Jacques; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Olagunju, Andrew T; Olagunju, Tinuke O; Owolabi, Mayowa Ojo; Pandian, Jeyaraj Durai; Patel, Shanti; Perico, Norberto; Piradov, Michael A; Polinder, Suzanne; Postma, Maarten J; Poustchi, Hossein; Prakash, V; Qorbani, Mostafa; Rafiei, Alireza; Rahim, Fakher; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Muhammad Aziz; Reis, Cesar; Remuzzi, Giuseppe; Renzaho, Andre M.N.; Ricci, Stefano; Roberts, Nicholas L S; Robinson, Stephen R; Roever, Leonardo; Roshandel, Gholamreza; Sabbagh, Parisa; Safari, Hosein; Safari, Saeed; Safiri, Saeid; Sahebkar, Amirhossein; Salehi Zahabi, Saleh; Samy, Abdallah M.; Santalucia, Paola; Santos, Itamar S; Santos, João Vasco; Santric Milicevic, Milena M; Sartorius, Benn; Sawant, Arundhati R; Schutte, Aletta Elisabeth; Sepanlou, Sadaf G.; Shafieesabet, Azadeh; Shaikh, Masood Ali; Shams-Beyranvand, Mehran; Sheikh, Aziz; Sheth, Kevin N.; Shibuya, Kenji; Shigematsu, Mika; Shin, Min-Jeong; Shiue, Ivy; Siabani, Soraya; Sobaih, Badr Hasan; Sposato, Luciano A.; Sutradhar, Ipsita; Sylaja, PN; Szoeke, Cassandra E I; Te Ao, Braden James; Temsah, Mohamad-Hani; Temsah, Omar; Thrift, Amanda G; Tonelli, Marcello; Topor-Madry, Roman; Tran, Bach Xuan; Tran, Khanh Bao; Truelsen, Thomas Clement; Tsadik, Afewerki Gebremeskel; Ullah, Irfan; Uthman, Olalekan A; Vaduganathan, Muthiah; Valdez, Pascual R; Vasankari, Tommi Juhani; Vasanthan, Rajagopalan; Venketasubramanian, Narayanaswamy; Vosoughi, Kia; Vu, Giang Thu; Waheed, Yasir; Weiderpass, Elisabete; Weldegwergs, Kidu Gidey; Westerman, Ronny; Wolfe, Charles D A; Wondafrash, Dawit Zewdu; Xu, Gelin; Yadollahpour, Ali; Yamada, Tomohide; Yatsuya, Hiroshi; Yimer, Ebrahim M; Yonemoto, Naohiro; Yousefifard, Mahmoud; Yu, Chuanhua; Zaidi, Zoubida; Zamani, Mohammad; Zarghi, Afshin; Zhang, Yunquan; Zodpey, Sanjay; Feigin, Valery L.; Vos, Theo; Murray, Christopher J L;
• Is Part Of: Lancet neurology. Volume 18:Issue 5(2019)
• Page Start: 439
• Page End: 458
• Publication Date: 2019-05
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Nervous System Diseases -- Periodicals; Neurologie -- Périodiques; Neurology; Electronic journals; Periodicals; 616.805
• DOI: 10.1016/S1474-4422(19)30034-1
• Languages: English
• ISSNs: 1474-4422

Abstract

Summary: 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