Background and purpose:Prediction of stroke impact provides essential information for healthcare planning and priority setting. We aim to estimate 30-year projections of stroke epidemiology in the European Union using multiple modeling approaches.Methods:Data on stroke incidence, prevalence, deaths, and disability-adjusted life years in the European Union between 1990 and 2017 were obtained from the global burden of disease study. Their trends over time were modeled using 3 modeling strategies: linear, Poisson, and exponential regressions―adjusted for the gross domestic product per capita, which reflects the impact of economic development on health status. We used the Akaike information criterion for model selection. The 30-year projections up to 2047 were estimated using the best fitting models, with inputs on population projections from the United Nations and gross domestic product per capita prospects from the World Bank. The technique was applied separately by age-sex-country groups for each stroke measure.Results:In 2017, there were 1.12 million incident strokes in the European Union, 9.53 million stroke survivors, 0.46 million deaths, and 7.06 million disability-adjusted life years lost because of stroke. By 2047, we estimated an additional 40 000 incident strokes (+3%) and 2.58 million prevalent cases (+27%). Conversely, 80 000 fewer deaths (–17%) and 2.31 million fewer disability-adjusted life years lost (–33%) are projected. The largest increase in the age-adjusted incidence and prevalence rates are expected in Lithuania (average annual percentage change, 0.48% and 0.7% respectively), and the greatest reductions in Portugal (–1.57% and –1.3%). Average annual percentage change in mortality rates will range from −2.86% (Estonia) to −0.08% (Lithuania), and disability-adjusted life years’ from −2.77% (Estonia) to −0.23% (Romania).Conclusions:The number of people living with stroke is estimated to increase by 27% between 2017 and 2047 in the European Union, mainly because of population ageing and improved survival rates. Variations are expected to persist between countries showing opportunities for improvements in prevention and case management particularly in Eastern Europe.

中文翻译：

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欧洲的中风负担：发病率，患病率，死亡人数和伤残调整生命年的三十年预测。

背景和目的：中风影响的预测为医疗保健计划和确定优先重点提供了重要信息。我们旨在使用多种建模方法来估算欧盟中风流行病学的30年预测方法：方法：从全球获得1990年至2017年之间欧盟中风发病率，患病率，死亡率和残疾调整生命年的数据疾病负担研究。使用三种建模策略对它们随时间的趋势进行建模：线性，泊松和指数回归（针对人均国内生产总值进行了调整），这反映了经济发展对健康状况的影响。我们使用Akaike信息准则进行模型选择。使用最佳拟合模型估算了到2047年的30年预测，联合国对人口预测的投入以及世界银行对人均国内生产总值的投入。结果：2017年，欧盟有112万起中风，953万中风幸存者，46万例死亡，706万残疾调整生命年因中风而迷路。到2047年，我们估计还会有4万起中风（+ 3％）和258万例流行病例（+ 27％）。相反，预计死亡人数将减少80,000人（–17％），残疾调整生命年减少231万（–33％）。预期在立陶宛，年龄调整后的发病率和患病率将增加最大（平均年百分率分别为0.48％和0.7％），而在葡萄牙则减少幅度最大（–1）。57％和–1.3％）。死亡率的年平均百分比变化范围为-2.86％（爱沙尼亚）至-0.08％（立陶宛），以及残疾调整生命年的范围为-2.77％（爱沙尼亚）至-0.23％（罗马尼亚）。据估计，在欧洲联盟2017年至2047年间，卒中患者的数量将增加27％，这主要是由于人口老龄化和生存率提高。预计各国之间仍将保持差异，这显示出改善预防和案件管理的机会，尤其是在东欧。据估计，在欧洲联盟2017年至2047年期间，中风患者的数量将增加27％，这主要是由于人口老龄化和生存率提高。预计各国之间将继续存在差异，显示出改善预防和病例管理的机会，尤其是在东欧。据估计，在欧洲联盟2017年至2047年期间，中风患者的数量将增加27％，这主要是由于人口老龄化和生存率提高。预计各国之间将继续存在差异，显示出改善预防和病例管理的机会，尤其是在东欧。