从1990年到2019年,美国的缺血性和出血性中风负担
Daniela Renedo1,2, Julian N Acosta1, Audrey C Leasure1
1Department of Neurology, Yale School of Medicine, New Haven, Connecticut.
JAMA neurology
|March 4, 2024
概括
美国的中风负担正在增加,尽管年龄标准化率下降,但更多的出血性中风正在增加. 针对性的公共卫生干预非常重要,因为中风趋势在各个年龄组和地区的差异.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 神经学 神经学
背景情况:
- 在美国,中风是导致死亡和残疾的主要原因.
- 准确的中风负担指标对于有效的公共卫生政策制定至关重要.
研究的目的:
- 估计2019年美国缺血性和出血性中风的负担.
- 分析从1990年到2019年的中风趋势,按年龄,性别和地理分层.
主要方法:
- 使用2019年全球疾病负担研究数据进行横截面分析.
- 对中风发病率,患病率,死亡率和因残疾而调整的寿命年 (DALY) 的检查.
- 分析的重点是所有中风,缺血性中风,脑内出血 (ICHs) 和脑下出血 (SAHs).
主要成果:
- 2019年,美国有709万次流行性中风,主要是缺血性 (82.7%).
- 从1990年到2019年,绝对中风病例,死亡率和DALY增加,而年龄标准化率下降或稳定.
- 出血性中风的发病率和死亡率显著增加,特别是ICH和SAH,具有显著的地理和人口差异.
结论:
- 年龄标准化中风率的下降表明进展,但绝对负担的上升和出血性中风的增加构成了重大的公共卫生挑战.
- 在不同年龄组和地区中风趋势的差异需要定制的干预措施和政策.
- 应对不断变化和不断升级的中风负担需要特定于地区和人口统计学的战略.
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