Contemporary burden of subarachnoid hemorrhage: a comparative assessment of global and Asian trend

To analyze the trends in the global and Asian burden of subarachnoid hemorrhage (SAH) from 1990 to 2021, explore its influencing factors, assess its relationship with sociodemographic development, analyze health inequalities, and predict future trends.

Epidemiological data on SAH from 1990 to 2021 were obtained from the Global Burden of Disease (GBD) database. Prevalence, disability-adjusted life years (DALYs), and other indicators were calculated. Joinpoint regression, age-period-cohort analysis, and decomposition analysis were used to investigate trends and influencing factors. Data envelopment analysis was employed to evaluate the relationship between SAH and the socio-demographic index (SDI). The slope index of inequality (SII) and concentration index (CI) were used to analyze health inequalities. The Bayesian age-period-cohort model was utilized to predict prevalence from 2022 to 2036.

In 2021, the global and Asian age-standardized prevalence of SAH was 92.169/100,000 and 90.158/100,000, respectively. Joinpoint regression showed a decreasing trend in both global and Asian prevalence, with a slowing decline in recent years. The risk of SAH exhibited significant age, period, and cohort effects. Decomposition analysis indicated that population growth and aging were the main drivers of increased prevalence globally and in Asia. Data envelopment analysis revealed a nonlinear relationship between SAH and SDI. SII and CI analyses showed a trend of increasing health inequalities globally and in Asia. Bayesian predictions indicated that the prevalence would continue to decline globally and in Asia from 2022 to 2036, but at a slower rate.

Although the global and Asian burden of SAH showed a declining trend over the past 30 years, challenges such as population aging and increasing health inequalities persist. Future prevention and control strategies should focus on population effects and regional heterogeneity while strengthening interventions for high-risk populations.