Global, regional, and national burden of stroke, 1990–2016

a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 Stroke Collaborators

Research output: Contribution to journalArticle

12 Citations (Scopus)

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

Original languageEnglish
Pages (from-to)439-458
Number of pages20
JournalThe Lancet Neurology
Volume18
Issue number5
DOIs
Publication statusPublished - 01-05-2019

Fingerprint

Stroke
Quality-Adjusted Life Years
Demography
Mortality
Uncertainty
Incidence
Literature
Global Burden of Disease
Birth Rate
Transient Ischemic Attack
Cerebral Hemorrhage
Wounds and Injuries
Subarachnoid Hemorrhage
Health Policy
Administrative Personnel
Health Care Costs
Atrial Fibrillation
Registries
Autopsy
Economics

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

@article{4a20232383704a0daabbd23a00e9ebe8,
title = "Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016",
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",
author = "{GBD 2016 Stroke Collaborators} and Johnson, {Catherine Owens} and Minh Nguyen and Roth, {Gregory A.} and Emma Nichols and Tahiya Alam and Degu Abate and Foad Abd-Allah and Ahmed Abdelalim and Abraha, {Haftom Niguse} and Abu-Rmeileh, {Niveen ME} and Adebayo, {Oladimeji M.} and Adeoye, {Abiodun Moshood} and Gina Agarwal and Sutapa Agrawal and Aichour, {Amani Nidhal} and Ibtihel Aichour and Aichour, {Miloud Taki Eddine} and Fares Alahdab and Raghib Ali and Nelson Alvis-Guzman and Anber, {Nahla Hamed} and Mina Anjomshoa and Jalal Arabloo and Antonio Arauz and Johan {\"A}rnl{\"o}v and Amit Arora and Ashish Awasthi and Maciej Banach and Barboza, {Miguel A.} and Barker-Collo, {Suzanne Lyn} and B{\"a}rnighausen, {Till Winfried} and Sanjay Basu and Belachew, {Abate Bekele} and Belayneh, {Yaschilal Muche} and Bennett, {Derrick A.} and Bensenor, {Isabela M.} and Krittika Bhattacharyya and Belete Biadgo and Ali Bijani and Boris Bikbov and {Bin Sayeed}, {Muhammad Shahdaat} and Butt, {Zahid A.} and Lucero Cahuana-Hurtado and Carrero, {Juan J.} and F{\'e}lix Carvalho and Casta{\~n}eda-Orjuela, {Carlos A.} and Franz Castro and Ferr{\'a}n Catal{\'a}-L{\'o}pez and Yazan Chaiah and Hiroshi Yatsuya",
year = "2019",
month = "5",
day = "1",
doi = "10.1016/S1474-4422(19)30034-1",
language = "English",
volume = "18",
pages = "439--458",
journal = "The Lancet Neurology",
issn = "1474-4422",
publisher = "Lancet Publishing Group",
number = "5",

}

Global, regional, and national burden of stroke, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016. / GBD 2016 Stroke Collaborators.

In: The Lancet Neurology, Vol. 18, No. 5, 01.05.2019, p. 439-458.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Global, regional, and national burden of stroke, 1990–2016

T2 - a systematic analysis for the Global Burden of Disease Study 2016

AU - GBD 2016 Stroke Collaborators

AU - Johnson, Catherine Owens

AU - Nguyen, Minh

AU - Roth, Gregory A.

AU - Nichols, Emma

AU - Alam, Tahiya

AU - Abate, Degu

AU - Abd-Allah, Foad

AU - Abdelalim, Ahmed

AU - Abraha, Haftom Niguse

AU - Abu-Rmeileh, Niveen ME

AU - Adebayo, Oladimeji M.

AU - Adeoye, Abiodun Moshood

AU - Agarwal, Gina

AU - Agrawal, Sutapa

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Aichour, Miloud Taki Eddine

AU - Alahdab, Fares

AU - Ali, Raghib

AU - Alvis-Guzman, Nelson

AU - Anber, Nahla Hamed

AU - Anjomshoa, Mina

AU - Arabloo, Jalal

AU - Arauz, Antonio

AU - Ärnlöv, Johan

AU - Arora, Amit

AU - Awasthi, Ashish

AU - Banach, Maciej

AU - Barboza, Miguel A.

AU - Barker-Collo, Suzanne Lyn

AU - Bärnighausen, Till Winfried

AU - Basu, Sanjay

AU - Belachew, Abate Bekele

AU - Belayneh, Yaschilal Muche

AU - Bennett, Derrick A.

AU - Bensenor, Isabela M.

AU - Bhattacharyya, Krittika

AU - Biadgo, Belete

AU - Bijani, Ali

AU - Bikbov, Boris

AU - Bin Sayeed, Muhammad Shahdaat

AU - Butt, Zahid A.

AU - Cahuana-Hurtado, Lucero

AU - Carrero, Juan J.

AU - Carvalho, Félix

AU - Castañeda-Orjuela, Carlos A.

AU - Castro, Franz

AU - Catalá-López, Ferrán

AU - Chaiah, Yazan

AU - Yatsuya, Hiroshi

PY - 2019/5/1

Y1 - 2019/5/1

N2 - 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

AB - 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

UR - http://www.scopus.com/inward/record.url?scp=85063992632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063992632&partnerID=8YFLogxK

U2 - 10.1016/S1474-4422(19)30034-1

DO - 10.1016/S1474-4422(19)30034-1

M3 - Article

VL - 18

SP - 439

EP - 458

JO - The Lancet Neurology

JF - The Lancet Neurology

SN - 1474-4422

IS - 5

ER -