Abstract
BACKGROUND: Severe heart failure (SHF) attributable to intracerebral hemorrhage (ICH), ischemic heart disease (IHD), and stroke imposes a substantial global health burden, exhibiting significant disparities across regions and demographic groups. This study systematically evaluates the years lived with disability (YLDs) and hospitalization burden associated with SHF resulting from these conditions. METHODS: Using data from the Global Burden of Disease 2021 (GBD 2021) study, we quantified the absolute number of YLDs, age-standardized rates (ASRs), And their temporal trends attributable to SHF caused by ICH, IHD, And stroke from 1990 to 2021. Analyses were stratified by gender, age group, region, socio-demographic index (SDI) level, And country. Regional And national-level assessments examined correlations between SHF-related YLDs and SDI. The Norpred model was applied to project SHF YLDs associated with various risk factors from 2022 to 2040. Additionally, single-center clinical data were analyzed to assess hospitalization burden linked to specific risk factors. RESULTS: From 1990 to 2021, both absolute numbers and ASRs of SHF-related YLDs attributable to IHD were consistently and significantly higher than those due to ICH and stroke. While ASRs for ICH- and stroke-related SHF showed an overall decline, ASRs for IHD-related SHF increased steadily, with a larger absolute growth. Norpred projections suggest this upward trend will continue over the next decade. Subgroup analyses indicated significantly higher YLDs among males and older individuals. Regionally, YLDs associated with ICH- and stroke-related SHF were highest in Africa and East Asia, whereas IHD-related SHF YLDs predominated in Australasia, Eastern Europe, and the North Africa and Middle East regions. Correlation analyses revealed a negative association between SDI and YLDs for ICH- and stroke-related SHF, in contrast to a positive association for IHD-related SHF. Clinical data demonstrated median hospitalization costs exceeding ¥23,318, with An average length of stay of 11 days; hospitalization burden was greatest for ICH-related SHF, followed by IHD. CONCLUSIONS: SHF attributable to ICH, IHD, and stroke continues to represent a major global health challenge, driven by aging populations and socioeconomic disparities. Targeted prevention, early screening, and cost-effective therapeutic interventions tailored to regional risk profiles are urgently required to mitigate the anticipated increases in healthcare burden.