Evaluating the Rehabilitation Needs of Stroke Patients in China: A Trend Analysis From 1990 to 2019

Stroke remains a leading cause of death and long-term disability in China. Rehabilitation is known to be an effective intervention for reducing disability among stroke survivors. This study seeks to quantify the rehabilitation needs of stroke patients in China by analyzing prevalence and years lived with disability (YLDs).

To assess rehabilitation needs, we first estimated the prevalence and YLDs among stroke patients in China using data from the Global Burden of Disease Study 2019. The WHO Rehabilitation Need Estimator was then applied to these estimates to derive the rehabilitation requirements.

Our study reveals a substantial need for stroke rehabilitation services in China in 2019. An estimated 25.0 million stroke patients (95% uncertainty interval [UI] 22.0-28.0) could benefit from these services, accounting for 6.1 million years lived with disability (YLDs) [4.3-7.8]. This burden is disproportionately distributed between genders, with males experiencing 11.0 [9.5-12.0] million prevalent cases and 2.5 [1.8-3.2] million YLDs, compared to females with 14.0 [12.0-16.0] million cases and 3.6 [2.5-4.8] million YLDs. Worryingly, the age-standardized prevalence of stroke in China has increased by 15.2% since 1990, rising from 11.2 per 1000 (95UI, 10.1-12.5) to 12.9 per 1000 (95UI, 11.5-14.4). Similarly, the age-standardized YLD rate has grown by 15.8%, from 2.72 per 1000 (95UI, 1.94-3.49) to 3.15 per 1000 (95UI, 2.21-4.48). This upward trend in China contrasts sharply with the global picture, where age-standardized prevalence and YLD rates have decreased by 6.2% and 4.8%, respectively.

These findings demonstrate a critical need for expanded access to rehabilitation services within China's stroke care system. To enhance patient outcomes and address this growing need, increased investment in stroke rehabilitation infrastructure, training, and research is essential.