Disability burden due to stroke in Western Australia: new insights from linked data sources

作者：Katzenellenbogen Judith M^*; Begg Stephen; Somerford Peter; Anderson Craig S; Semmens James B; Codde James P; Vos Theo

来源：International Journal of Stroke, 2010, 5(4): 269-277.

DOI：10.1111/j.1747-4949.2010.00439.x

• chronic disease
• DALY
• disability
• epidemiology
• methodology
• stroke

Background
The disability-adjusted life year index is used extensively to compare disease burden among diseases and locations, but difficulties remain in accurately estimating the nonfatal stroke burden in years lived with disability.
Aims
To improve stroke-related years lived with disability estimates in Western Australia for 2000, by improving the accuracy of component inputs: nonfatal (28-day survivor) incidence, disease duration and disability (severity) weights.
Methods
Nonfatal stroke incidence and the mortality difference between prevalent cases and the general population were estimated from linked hospital and mortality data using the Western Australian Data Linkage System. dismod software used these inputs to model disease duration. Disability weights were estimated from population-based stroke survey data, using indirect health valuation methods and adjusting for prestroke disability. Years lived with disability were calculated from the three components.
Results
The annual age-standardised nonfatal incidence (n=1985) was higher in males (121/100 000) than females (96/100 000). The duration varied between 35 center dot 8 (females 15-24 years) and 3 center dot 4 years (males 85+ years). The mean pre-stroke-adjusted disability weight was higher at 4-months (0 center dot 38) than at 12-months (0 center dot 31). The age-standardised rate of nonfatal burden in males (302/100 000; 95% CI 290-314) was significantly higher than that in females (250/100 000; 95% CI 240-260). The nonfatal proportion of stroke burden (males 45%; females 37%) was higher than estimated in previous studies.
Conclusion
This study illustrates that previous reports most likely underestimated disability burden as a contributor to the total stroke burden in Australia. Methodological refinements will contribute to burden of disease studies elsewhere.

• 出版日期2010-8