"Global, regional, and national time trends in mortality for stroke, 1990-2019: An age-period-cohort analysis for the global burden of disease 2019 study and implications for stroke prevention"

作者全名："Peng, Shengxian; Liu, Xiaozhu; Cao, Wenzhai; Liu, Yue; Liu, Yuan; Wang, Wei; Zhang, Ting; Guan, Xiaoyan; Tang, Juan; Zhang, Qingwei"

作者地址："[Peng, Shengxian; Liu, Yue; Liu, Yuan; Guan, Xiaoyan; Tang, Juan] First Peoples Hosp Zigong City, Sci Res Dept, Zigong, Peoples R China; [Liu, Xiaozhu] Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 2, Chongqing, Peoples R China; [Cao, Wenzhai] First Peoples Hosp Zigong City, Dept Cardiol, Zigong, Peoples R China; [Wang, Wei] First Peoples Hosp Zigong City, Informat Dept, Zigong, Peoples R China; [Zhang, Ting] Sichuan Vocat Coll Hlth & Rehabil, Sci Res Ctr, Zigong, Peoples R China; [Zhang, Qingwei] Shanghai Jiao Tong Univ, Renji Hosp, Shanghai Inst Digest Dis, Sch Med,Key Lab Gastroenterol & Hepatol,Div Gastro, Shanghai, Peoples R China; [Zhang, Qingwei] Shanghai Jiao Tong Univ, Div Gastroenterol & Hepatol, Renji Hosp, Sch Med,NHC Key Lab Digest Dis,Shanghai Inst Diges, Shanghai, Peoples R China"

通信作者："Zhang, QW (通讯作者)，Shanghai Jiao Tong Univ, Div Gastroenterol & Hepatol, Renji Hosp, Sch Med,NHC Key Lab Digest Dis,Shanghai Inst Diges, Shanghai, Peoples R China."

来源：INTERNATIONAL JOURNAL OF CARDIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001011657300001

JCR分区：Q2

影响因子：3.2

年份：2023

卷号：383

期号：　

开始页：117

结束页：131

文献类型：Article

关键词：Stroke; Mortality; Age -period -cohort; Health variances

摘要："Background: Despite the fact that stroke is the second leading cause of death globally, a comprehensive and comparable assessment of mortality, and epidemiologic trends has not been conducted for most regions.We estimated the global and regional burden of stroke from 1990 to 2019 using data from the 2019 Global Study of Diseases, Injuries, and Risk Factors.Methods: For the period between 1990 and 2019, we used an age-period-cohort model to calculate the annual percentage changes in mortality (net drifts), local drifts, and period and cohort relative risks (period/cohort effects). Meanwhile, to quantify the temporal trends in stroke age-standardised mortality rate (ASMR), Average annual percentage changes (AAPCs) were determined by sex, area. With the potential to uncover disparities and treatment gaps in stroke care, this approach enables the examination and differentiation of age, period, and cohort effects in mortality trends.Findings: Global stroke deaths in 2019 were 6,552,725 (95% UI 5,995,200 to 7,015,139). Between 1990 and 2019, the ASMR declined globally by 36.43% (95% UI-41.65 to-31.2), with decreases in all SDI quintiles. The net drift in stroke mortality from 1990 to 2019 varied from-2.83% per year (95% confidence interval [CI]:-3.39 to-2.77) in countries with a high Socio-demographic Index (SDI) to-1.21% per year (95% CI:-1.26 to-1.16) in countries with a low SDI. During the past 30 years, favorable mortality reductions were generally found in high-SDI countries (net drift =-3.1% [95% CI:-3.4 to-2.8] per year) and high-middle SDI countries (-2.8% [-3.0 to-2.6]). However, 31 of 204 countries had either increasing trends (net drifts & GE;0.0%) or stagnated reductions (& GE; -0.5%) in mortality. The relative risk of mortality generally showed improving trends over time and in successively younger birth cohorts among high and high-middle SDI countries, with the exceptions of Kuwait, Ukraine, Kazakhstan, Guam, RussianFederation, Lithuania, Turkey, Montenegro, Serbia, Bosnia and Herzegovin, and Bulgaria.Interpretation: Notwithstanding mortality from stroke has increased globally over the past 30 years, adverse period and cohort effects have been found in many countries, calling into question the adequacy of healthcare for stroke patients of all ages. These lapses have a significant impact on the likelihood of achieving the Sustainable Development Goal (SDG) targets on mortality from age 60+ and NCDs."

基金机构：Zigong Science and Technology Project [2015ZC02]; Medical and Health Own Fund Guiding Project of Zigong Academy of Medical Sciences [2020YXY03]

基金资助正文：Funding This study was funded by the Zigong Science and Technology Project (NO. 2015ZC02) and the Medical and Health Own Fund Guiding Project of Zigong Academy of Medical Sciences (NO. 2020YXY03) .