Global, regional, and national burden of intracerebral hemorrhage and its attributable risk factors in youth from 1990 to 2021: a Global Burden of Disease study

Objective: To quantify the global, regional, and national incidence, mortality, and disability-adjusted life years (DALYs) of intracerebral hemorrhage among youth (15–49 years) from 1990 to 2021, and to evaluate the contributions of major attributable risk factors using the GBD 2021 framework. The findings are intended to provide an updated descriptive overview that may inform future research and offer reference points for public health planning. Methods: Data were obtained from the Global Burden of Disease (GBD) study conducted in 2021. Time trends in the incidence, mortality, and DALYs of youth intracerebral hemorrhage(ICH) were assessed using estimated annual percentage changes. Risk factors associated with ICH were selected, including six environmental/occupational factors, eight behavioral risks, and four metabolic factors. Age-standardised rates and the percentages of DALYs attributable to these risk factors were calculated. Results: In 2021, there were 610,000 cases, 260,000 deaths, and 13.79 million DALYs due to ICH globally. Between 1990 and 2021, age-standardised rates of incidence, mortality, and DALYs decreased, while the absolute numbers of incidence, deaths, and DALYs increased. Globally, approximately 79.68% of the age-standardised DALY rate for ICH among individuals aged 15 to 49 years was attributable to the risk factors listed in the GBD 2021 dataset. In 2021, the primary risk factors for youth ICH were high systolic blood pressure (SBP) (46.59%), smoking (21.37%), ambient particulate matter pollution (14.92%), household air pollution from solid fuels (14.64%), and diet low in fruits (13.53%). Among them, a high body mass index (BMI) has the greatest increase in the impact on ICH. Conclusion: The burden of ICH remains substantial among young individuals, with metabolic risk factors identified as the primary contributors. These findings provide updated comparative evidence that may inform future research and offer reference points for public health planning.