Epidemiology, Incidence and Global Burden of Stroke: Difference between revisions

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== Introduction  ==
== Introduction  ==


According to the [http://www.thelancet.com/gbd/2010 2010 Global Burden of Disease Study], Stroke categorised under Cardiovascular and Circulatory Diseases, is the second leading cause of death globally and the third leading cause of premature death and disability as measured in Disability Adjusted Life Years (DALY).  Cerebrovascular disease is the largest neurologic contributor and accounts for 4.1% of total global DALY.  
According to the [http://www.thelancet.com/gbd/2010 2010 Global Burden of Disease Study], Stroke categorised under Cardiovascular and Circulatory Diseases, is the second leading cause of death globally and the third leading cause of premature death and disability as measured in Disability Adjusted Life Years (DALY). Cerebrovascular disease is the largest neurologic contributor and accounts for 4.1% of total global DALY.  


Identification and adequate management of risk factors are key to preventing any disease or injury. Many factors are relevant in prioritising strategies to reduce risks to health. These include the extent of the threat posed by different risk factors, the availability of cost-effective interventions, societal values, culture and preferences. Risk assessment and estimates of the burden of disease resulting from different risk factors may be altered by many different strategies. Feigin et al<ref name="Feigin1">Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M. [http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61953-4.pdf Global and Regional Burden of Stroke during 1990–2010: Findings from the Global Burden of Disease Study 2010]. The Lancet. 2014 Jan 24;383(9913):245-55.</ref> analyse the Global and Regional Burden of Stroke between 1990-2010 and provide an update on the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischaemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013<ref name="Feigin2">Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, Davis S. [http://www.karger.com/Article/Pdf/441085 Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study]. Neuroepidemiology. 2015 Oct 28;45(3):161-76.</ref><ref name="Feigin3">Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K. [http://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(16)30073-4.pdf Global Burden of Stroke and Risk Factors in 188 Countries, during 1990–2013: A Systematic Analysis for the Global Burden of Disease Study 2013]. The Lancet Neurology. 2016 Aug 31;15(9):913-24</ref>.
== Global Burden of Stroke ==


Feigin et al<ref name="Feigin4">Feigin VL, Mensah GA, Norrving B, Murray CJ, Roth GA. [http://www.karger.com/Article/Pdf/441106 Atlas of the Global Burden of Stroke (1990-2013): the GBD 2013 study]. Neuroepidemiology. 2015 Oct 28;45(3):230-6</ref> 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 <br>
Identification and adequate management of risk factors are key to preventing any disease or injury. Many factors are relevant in prioritising strategies to reduce risks to health. These include the extent of the threat posed by different risk factors, the availability of cost-effective interventions, societal values, culture and preferences. Risk assessment and estimates of the burden of disease resulting from different risk factors may be altered by many different strategies. Feigin et al<ref name="Feigin1">Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M. [http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61953-4.pdf Global and Regional Burden of Stroke during 1990–2010: Findings from the Global Burden of Disease Study 2010]. The Lancet. 2014 Jan 24;383(9913):245-55.</ref> analyse the Global and Regional Burden of Stroke between 1990-2010 and provided an update on the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischaemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013<ref name="Feigin2">Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, Davis S. [http://www.karger.com/Article/Pdf/441085 Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study]. Neuroepidemiology. 2015 Oct 28;45(3):161-76.</ref><ref name="Feigin3">Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K. [http://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(16)30073-4.pdf Global Burden of Stroke and Risk Factors in 188 Countries, during 1990–2013: A Systematic Analysis for the Global Burden of Disease Study 2013]. The Lancet Neurology. 2016 Aug 31;15(9):913-24</ref>.


Ovbiagele &amp; Nguyen-Huynh<ref name="Ovbiagel">Ovbiagele B, Nguyen-Huynh MN. Stroke Epidemiology: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250269/pdf/13311_2011_Article_53.pdf Advancing our Understanding of Disease Mechanism and Therapy]. Neurotherapeutics. 2011 Jul 1;8(3):319.</ref> highlight the role of epidemiologic studies in identifing groups of individuals or regions at higher risk for stroke, which they believe can also help us better understand the natural history of stroke and therefore push the direction of therapeutic investigations.  
Although age-standardised rates of stroke mortality have decreased worldwide, the absolute number of people who have a stroke every year, stroke survivors, related deaths, and the overall global burden of stroke (DALYs lost) are great and increasing. Further study is needed to improve understanding of stroke determinants and burden worldwide, and to establish causes of disparities and changes in trends in stroke burden between countries of different income levels<ref>Feigin1</ref>.


You can explore country specific visual and statistical data in relation to stroke at a "[http://www.thelancet.com/lancet/visualisations/cause-of-death Causes of death visualisation" tool on The Lancet].
Feigin et al<ref name="Feigin4">Feigin VL, Mensah GA, Norrving B, Murray CJ, Roth GA. [http://www.karger.com/Article/Pdf/441106 Atlas of the Global Burden of Stroke (1990-2013): the GBD 2013 study]. Neuroepidemiology. 2015 Oct 28;45(3):230-6</ref> show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischaemic stroke and hemorrhagic stroke in the world for 1990-2013 <br>


<br>
Ovbiagele &amp; Nguyen-Huynh<ref name="Ovbiagel">Ovbiagele B, Nguyen-Huynh MN. Stroke Epidemiology: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250269/pdf/13311_2011_Article_53.pdf Advancing our Understanding of Disease Mechanism and Therapy]. Neurotherapeutics. 2011 Jul 1;8(3):319.</ref> highlight the role of epidemiological studies in identifying groups of individuals or regions at higher risk for stroke, which they believe can also help us better understand the natural history of stroke and therefore push the direction of therapeutic investigations.


<br>In many countries and regions, Stroke Registers, are now being used to gain a greater understanding of the prevalence of Stroke and assist with research and service planning. These registers are databases of clinical information, with the primary aim being collection of key data items to provide information on the quality of care for individual patients with stroke and transient ischaemic attack (TIA) in order to provide high-quality information to identify areas where improvements in quality of care should be prioritised, reduce variations in care delivery and, ultimately, provide evidence of reduced deaths, disability, and recurrent stroke. Is there a Stroke Register in your Country? Do you keep a register within your practice of individuals with Stroke in order to plan for future service requirements?
You can explore country specific visual and statistical data in relation to Stroke at a "[http://www.thelancet.com/lancet/visualisations/cause-of-death Causes of death visualisation" tool on The Lancet].  


<br>
[[Image:Number of deaths by stroke globally from 1980-2015.png|center|600px]]
 
Optional


You can also examine the individual burden of Ischemic and Hemorrhagic Stroke:
== Individual burden of Ischaemic and Hemorrhagic Stroke ==


Krishnamurthi RV, Moran AE, Forouzanfar MH, Bennett DA, Mensah GA, Lawes CM, Barker-Collo S, Connor M, Roth GA, Sacco R, Ezzati M. The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Global heart. 2014 Mar 31;9(1):101-6.<br>Bennett DA,  
Krishnamurthi RV, Moran AE, Forouzanfar MH, Bennett DA, Mensah GA, Lawes CM, Barker-Collo S, Connor M, Roth GA, Sacco R, Ezzati M. The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Global heart. 2014 Mar 31;9(1):101-6.<br>Bennett DA,  


Krishnamurthi RV, Barker-Collo S, Forouzanfar MH, Naghavi M, Connor M, Lawes CM, Moran AE, Anderson LM, Roth GA, Mensah GA. The global burden of ischemic stroke: findings of the GBD 2010 study. Global heart. 2014 Mar 31;9(1):107-12.  
Krishnamurthi RV, Barker-Collo S, Forouzanfar MH, Naghavi M, Connor M, Lawes CM, Moran AE, Anderson LM, Roth GA, Mensah GA. The global burden of ischemic stroke: findings of the GBD 2010 study. Global heart. 2014 Mar 31;9(1):107-12.  
<br>
== Stroke Registers  ==
In many countries and regions, Stroke Registers, are now being used to gain a greater understanding of the prevalence of Stroke and assist with research and service planning. These registers are databases of clinical information, with the primary aim being collection of key data items to provide information on the quality of care for individual patients with stroke and transient ischaemic attack (TIA) in order to provide high-quality information to identify areas where improvements in quality of care should be prioritised, reduce variations in care delivery and, ultimately, provide evidence of reduced deaths, disability, and recurrent stroke.
*Is there a Stroke Register in your Country?
*Do you keep a register within your practice of individuals with Stroke in order to plan for future service requirements?


== References  ==
== References  ==


<references />
<references />

Revision as of 11:39, 27 April 2017

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Top Contributors - Rachael Lowe, Lucinda hampton, Kim Jackson, Simisola Ajeyalemi, Rucha Gadgil and Amanda Ager  

Introduction[edit | edit source]

According to the 2010 Global Burden of Disease Study, Stroke categorised under Cardiovascular and Circulatory Diseases, is the second leading cause of death globally and the third leading cause of premature death and disability as measured in Disability Adjusted Life Years (DALY). Cerebrovascular disease is the largest neurologic contributor and accounts for 4.1% of total global DALY.

Global Burden of Stroke[edit | edit source]

Identification and adequate management of risk factors are key to preventing any disease or injury. Many factors are relevant in prioritising strategies to reduce risks to health. These include the extent of the threat posed by different risk factors, the availability of cost-effective interventions, societal values, culture and preferences. Risk assessment and estimates of the burden of disease resulting from different risk factors may be altered by many different strategies. Feigin et al[1] analyse the Global and Regional Burden of Stroke between 1990-2010 and provided an update on the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischaemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013[2][3].

Although age-standardised rates of stroke mortality have decreased worldwide, the absolute number of people who have a stroke every year, stroke survivors, related deaths, and the overall global burden of stroke (DALYs lost) are great and increasing. Further study is needed to improve understanding of stroke determinants and burden worldwide, and to establish causes of disparities and changes in trends in stroke burden between countries of different income levels[4].

Feigin et al[5] show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischaemic stroke and hemorrhagic stroke in the world for 1990-2013

Ovbiagele & Nguyen-Huynh[6] highlight the role of epidemiological studies in identifying groups of individuals or regions at higher risk for stroke, which they believe can also help us better understand the natural history of stroke and therefore push the direction of therapeutic investigations.

You can explore country specific visual and statistical data in relation to Stroke at a "Causes of death visualisation" tool on The Lancet.

Number of deaths by stroke globally from 1980-2015.png

Individual burden of Ischaemic and Hemorrhagic Stroke[edit | edit source]

Krishnamurthi RV, Moran AE, Forouzanfar MH, Bennett DA, Mensah GA, Lawes CM, Barker-Collo S, Connor M, Roth GA, Sacco R, Ezzati M. The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Global heart. 2014 Mar 31;9(1):101-6.
Bennett DA,

Krishnamurthi RV, Barker-Collo S, Forouzanfar MH, Naghavi M, Connor M, Lawes CM, Moran AE, Anderson LM, Roth GA, Mensah GA. The global burden of ischemic stroke: findings of the GBD 2010 study. Global heart. 2014 Mar 31;9(1):107-12.


Stroke Registers[edit | edit source]

In many countries and regions, Stroke Registers, are now being used to gain a greater understanding of the prevalence of Stroke and assist with research and service planning. These registers are databases of clinical information, with the primary aim being collection of key data items to provide information on the quality of care for individual patients with stroke and transient ischaemic attack (TIA) in order to provide high-quality information to identify areas where improvements in quality of care should be prioritised, reduce variations in care delivery and, ultimately, provide evidence of reduced deaths, disability, and recurrent stroke.

  • Is there a Stroke Register in your Country?
  • Do you keep a register within your practice of individuals with Stroke in order to plan for future service requirements?

References[edit | edit source]

  1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M. Global and Regional Burden of Stroke during 1990–2010: Findings from the Global Burden of Disease Study 2010. The Lancet. 2014 Jan 24;383(9913):245-55.
  2. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, Davis S. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study. Neuroepidemiology. 2015 Oct 28;45(3):161-76.
  3. Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K. Global Burden of Stroke and Risk Factors in 188 Countries, during 1990–2013: A Systematic Analysis for the Global Burden of Disease Study 2013. The Lancet Neurology. 2016 Aug 31;15(9):913-24
  4. Feigin1
  5. Feigin VL, Mensah GA, Norrving B, Murray CJ, Roth GA. Atlas of the Global Burden of Stroke (1990-2013): the GBD 2013 study. Neuroepidemiology. 2015 Oct 28;45(3):230-6
  6. Ovbiagele B, Nguyen-Huynh MN. Stroke Epidemiology: Advancing our Understanding of Disease Mechanism and Therapy. Neurotherapeutics. 2011 Jul 1;8(3):319.