Abstract WP231: The Temporal Trends in the Burden of Intracerebral Hemorrhage in a Developing Middle Eastern Country Over 3 Decades

Introduction: Intracerebral hemorrhage (ICH) imposes a significant health burden due to the associated morbidity and mortality. Evaluation of the burden of ICH, and the temporal trends of this burden, is of paramount significance in determining the shifting paradigms and in the introduction of effective measures at both, preventative and therapeutic levels, particularly in developing Middle Eastern nations with limited resources such as Jordan. Methods: The burden of ICH in Jordan over the period 1990-2019 was evaluated by initially retrieving relevant data, including age-standardized rates per 100,000 persons, regarding the mortality, incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs) from the Global Burden of Disease database. Temporal trends were evaluated by calculating the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) using Joinpoint Analysis software. Results: An estimated total of 20,294 ICH-related mortalities with a female predominance of approximately 52.7% were reported in Jordan over a span of around 30 years. There is an overall decline in ICH-related age-standardized mortality rate with an AAPC of -3.36 (95CI% -3.45 to -3.26; p<0.0001). Stratification by sex demonstrated a statistically significant decline in both males and females, with the latter having a more prominent decline in age-standardized mortality rates with an AAPC of -3.59 (95CI% -3.88 to -3.27; p<0.0001), whereas males had an AAPC of -2.82 (95%CI -2.87 to -2.77; p<0.0001). In terms of age-standardized prevalence and incidence rates, statistically significant declines were also noted with the age-standardized incidence rate witnessing an AAPC of -2.31 (95%CI -2.33 to -2.29; p<0.0001) and the age-standardized prevalence rate witnessing an AAPC of -1.57 (95CI% -1.59 to -1.56; p<0.0001). A total of 739 thousand DALYs were attributable to ICH in Jordan over the 30 years. However, A statistically significant decline in age-standardized DALY rate was noted with an AAPC of -3.76 (95%CI -3.83 to -3.68; p<0.0001). A significant decline was noted in the age-standardized YLD rate with an AAPC of -1.54 (95%CI -1.56 to -1.52; p<0.0001). Conclusion: In conclusion, the burden of ICH in Jordan has been witnessing a progressive decline over the period of 3 decades. This can be attributed to better access to care, but comparison to neighboring countries is warranted to identify the driving factors behind this decline.