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. 2015;45(3):230-6.
doi: 10.1159/000441106. Epub 2015 Oct 28.

Atlas of the Global Burden of Stroke (1990-2013): The GBD 2013 Study

Collaborators, Affiliations

Atlas of the Global Burden of Stroke (1990-2013): The GBD 2013 Study

Valery L Feigin et al. Neuroepidemiology. 2015.

Abstract

Background: World mapping is an important tool to visualize stroke burden and its trends in various regions and countries.

Objectives: To show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke and hemorrhagic stroke in the world for 1990-2013.

Methodology: Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated following the general approach of the Global Burden of Disease (GBD) 2010 with several important improvements in methods. Data were updated for mortality (through April 2014) and stroke incidence, prevalence, case fatality and severity through 2013. Death was estimated using an ensemble modeling approach. A new software package, DisMod-MR 2.0, was used as part of a custom modeling process to estimate YLDs. All rates were age-standardized to new GBD estimates of global population. All estimates have been computed with 95% uncertainty intervals.

Results: Age-standardized incidence, mortality, prevalence and DALYs/YLDs declined over the period from 1990 to 2013. However, the absolute number of people affected by stroke has substantially increased across all countries in the world over the same time period, suggesting that the global stroke burden continues to increase. There were significant geographical (country and regional) differences in stroke burden in the world, with the majority of the burden borne by low- and middle-income countries.

Conclusions: Global burden of stroke has continued to increase in spite of dramatic declines in age-standardized incidence, prevalence, mortality rates and disability. Population growth and aging have played an important role in the observed increase in stroke burden.

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Conflict of interest statement

Conflict of interest

The authors have no conflict of interest to declare.

Figures

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1
Age-standardized annual prevalence (per 100,000) of ischemic stroke in 2013
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Age-standardized annual prevalence (per 100,000) of hemorrhagic stroke in 2013
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Age-standardized annual mortality rates (per 100,000) of ischemic stroke in 2013
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Age-standardized annual mortality rates (per 100,000) of hemorrhagic stroke in 2013
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Age-standardized annual DALYs rates (per 100,000) due to ischemic stroke in 2013
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Age-standardized annual DALYs rates (per 100,000) due to hemorrhagic stroke in 2013
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Percent change in age-standardized prevalence due to ischemic stroke for 1990–2013
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Percent change in age-standardized prevalence due to hemorrhagic stroke for 1990–2013
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Percent change in age-standardized mortality rates due to ischemic stroke for 1990–2013
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Percent change in age-standardized mortality rates due to hemorrhagic stroke for 1990–2013

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