2005-2024年上海市静安区卒中疾病负担趋势分析及预测OA

Objective To analyze the trends of stroke mortality and disability-adjusted life year(DALY)rates among residents in Jing'an District,Shanghai from 2005 to 2024,and predict the stroke disease burden in this region from 2025 to 2030,so as to provide evidence for developing targeted stroke prevention and control strategies. Methods Data were derived from the death surveillance records of residents in Jing'an District,which were included in the death registration information system of the Shanghai Municipal Center for Disease Control and Prevention.Death cases with stroke as the underlying cause of death from January 1,2005 to December 31,2024 were extracted.The crude mortality was calculated,and the crude DALY rate was indirectly estimated based on the global burden of disease(GBD)2021 data.The age-standardized mortality and DALY rates were calculated using the world standard population age composition released by GBD 2021,hereinafter referred to as the world age-standardized mortality rate and world age-standardized DALY rate.The Joinpoint regression model was used to analyze the annual percent change(APC),average annual percent change(AAPC),temporal trends,and trend turning points of crude mortality rate,crude DALY rate,and their world age-standardized rates.The Bayesian age-period-cohort(BAPC)model was employed to predict the world age-standardized mortality and DALY rates in Jing'an District,Shanghai from 2025 to 2030. Results From 2005 to 2024,a total of 35 817 stroke-related deaths were reported in Jing'an District,Shanghai,accounting for 19.90％of all deaths in the district during the same period,among which ischemic stroke deaths accounted for 74.91％.The proportion of comorbidities,including hypertension,coronary heart disease,and diabetes mellitus,among stroke deaths showed a fluctuating upward trend.Joinpoint regression analysis revealed that the world age-standardized mortality(AAPC-2.23％,95％CI-2.95％--1.51％,P＜0.001)and world age-standardized DALY rate(AAPC-2.35％,95％CI-3.10％--1.60％,P＜0.001)for stroke in the overall population of Jing'an District,Shanghai from 2005 to 2024 both showed downward trends.Since 2016,the declining trends in the world age-standardized mortality and world age-standardized DALY rates for stroke in males have stagnated,yet the changes were not statistically significant.Age-stratified analysis revealed that residents aged 85 years and above had relatively high stroke mortality.Moreover,the declining trend in stroke mortality among those aged 65-74 reversed to an upward trend after 2017.The BAPC model predicted that the world age-standardized mortality and DALY rates for stroke in Jing'an District,Shanghai would continue to decline from 2025 to 2030. Conclusions Overall decreasing trends in the world age-standardized mortality and DALY rates for stroke were observed in Jing'an District,Shanghai from 2005 to 2024,reflecting favorable outcomes of regional stroke prevention and control.However,the declining trend in stroke disease burden among males has stagnated since 2016.With deepening population aging and growing chronic comorbidity burden,future stroke prevention and control should prioritize males and the elderly,and shift the management paradigm from single-disease intervention to integrated multimorbidity management.