Trends in global subarachnoid hemorrhage incidence among adolescents from 1990 to 2021 and their age-period-cohort model analysis and prediction
LIU Xiyu
ZHANG Bingying
HAO Guangzhi
XIA Qiutong
JIANG Chengguo
CHU Guangxin
Abstract：Objective To analyze the incidence trends of subarachnoid hemorrhage(SAH)and assess the impact of age,period,and cohort on their occurrences among adolescents and young adults(aged 15-39)from 1990 to 2021 and predict future trends in incidence,thereby provide valuable insights for the prevention and management of SAH in this demography.Methods Based on the 2021 Global Burden of Disease Database,this study extracted relevant statistical data related to the incidence and incidence rates of subarachnoid hemorrhage in the global adolescent and young adult population.A joinpoint regression model was employed to analyze the long-term trends of the age-standardized incidence rates for this group from 1990 to 2021.Annual percentage change(APC)and average annual percentage change(AAPC)were calculated to identify trend turning points and assess the overall magnitude of changes in incidence rates.Additionally,an age-period-cohort model was utilized to analyze the independent effects of age,period,and birth cohort on the incidence rates of subarachnoid hemorrhage in this population.Finally,the Nordpred model was used to predict future trends in global incidence rates.Results From 1990 to 2021,the incidence of subarachnoid hemorrhage(SAH)among the global population of adolescents and young adults increased from 73,678 cases to 79,619 cases,representing an 8.1%rise;the crude incidence rate decreased from 4.01 per 100,000 to 3.3 per 100,000,a decline of 17.71%;the age-standardized incidence rate fell from 4.12 per 100,000 to 3.25 per 100,000,a decrease of 21.1%.Joinpoint regression model analysis indicated that from 1990 to 2021 the overall age-standardized incidence rates of SAH among global adolescents and young adults,as well as among males and females,showed a general declining trend.The AAPC value for the entire population group was-0.77%(P<0.01).However,from 2014 to 2021,the incidence rate exhibited a reversal,demonstrating an upward trend,with the most significant increase occurring from 2019 to 2021,reflected in an APC value of 1.1%(P<0.01).Analysis of the age-period-cohort model showed that the risk of disease increased with age but decreased with period effects and birth cohort effects.Predictions indicated that from 2022 to 2044,the incidence rate of subarachnoid hemorrhage among the global adolescent and young adult population would experience a slight increase.Conclusions From 1990 to 2021,the standardized incidence rate of subarachnoid hemorrhage among global adolescents and youth has shown an overall declining trend,however,its evolution exhibits nonlinear characteristics:in recent years,the incidence rate has fluctuated and rebounded,while the absolute number of cases continues to rise,indicating that the disease burden remains concerning.Furthermore,the incidence rate among males consistently exceeds that of females,with significant differences observed in different periods and birth cohorts.Therefore,to further reduce the disease burden,it is essential to optimize health promotion strategies for youth based on risks related to gender,age,and historical context to achieve precise control over the global disease burden.
Keywords：subarachnoid hemorrhageGlobal Burden of Diseasejoinpoint regression modelage-period-cohort modelpredictive analysis
Publication Date：2026-01-28
Online Publishing Date：2026-01-17(First online date of this platform, not the publication date of the document)
Pages：8( 14-21 )