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Inicio Medicina Clínica (English Edition) The national burden of cerebrovascular diseases in Spain: A population-based stu...
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Vol. 144. Issue 8.
Pages 353-359 (April 2015)
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Vol. 144. Issue 8.
Pages 353-359 (April 2015)
Original article
DOI: 10.1016/j.medcle.2013.11.002
The national burden of cerebrovascular diseases in Spain: A population-based study using disability-adjusted life years
Carga de las enfermedades cerebrovasculares en España: estudio de base poblacional utilizando los años de vida ajustados por discapacidad
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Ferrán Catalá-Lópeza,b,
Corresponding author
ferran_catala@hotmail.com

Corresponding author.
, Nerea Fernández de Larrea-Bazc, Consuelo Morant-Ginestard, Elena Álvarez-Martíne, Jaime Díaz-Guzmánf, Ricard Gènova-Malerasg
a Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Madrid, Spain
b Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain
c Health Research, Training and Infrastructures General Directorate, Regional Health Council, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
d Unidad Docente de Medicina Familiar y Comunitaria Este, Ramón y Cajal University Hospital, Madrid, Spain
e Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain
f Stroke Unit, Neurology Department, 12 de Octubre University Hospital, Faculty of Medicine, Complutense University, Madrid, Spain
g Primary Care General Directorate, Regional Health Council, Madrid, Spain
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Figures (1)
Tables (4)
Table 1. Proportion of patients with cerebrovascular disease in Spain at each level of disability and the corresponding disability weight.
Table 2. Cerebrovascular diseases in Spain by age and sex: population, incidence and mortality (2008).
Table 3. Burden of cerebrovascular diseases in Spain by age and sex: years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY).
Table 4. Sensitivity analysis: comparison of outcome measures depending on the standard life table, age-weighting and/or discount rate used.
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Abstract
Background and objective

The aim of the present study was to determine the national burden of cerebrovascular diseases in the adult population of Spain.

Patients and methods

Cross-sectional, descriptive population-based study. We calculated the disability-adjusted life years (DALY) metric using country-specific data from national statistics and epidemiological studies to obtain representative outcomes for the Spanish population. DALYs were divided into years of life lost due to premature mortality (YLLs) and years of life lived with disability (YLDs). DALYs were estimated for the year 2008 by applying demographic structure by sex and age-groups, cause-specific mortality, morbidity data and new disability weights proposed in the recent Global Burden of Disease study. In the base case, neither YLLs nor YLDs were discounted or age-weighted. Uncertainty around DALYs was tested using sensitivity analyses.

Results

In Spain, cerebrovascular diseases generated 418,052 DALYs, comprising 337,000 (80.6%) YLLs and 81,052 (19.4%) YLDs. This accounts for 1,113 DALYs per 100,000 population (men: 1,197 and women: 1,033) and 3,912 per 100,000 in those over the age of 65 years (men: 4,427 and women: 2,033). Depending on the standard life table and choice of social values used for calculation, total DALYs varied by 15.3% and 59.9% below the main estimate.

Conclusions

Estimates provided here represent a comprehensive analysis of the burden of cerebrovascular diseases at a national level. Prevention and control programmes aimed at reducing the disease burden merit further priority in Spain.

Keywords:
Cerebrovascular disease
Stroke
Burden of disease
Disability-adjusted life years
Spain
Resumen
Fundamento y objetivo

El objetivo del presente estudio fue determinar la carga de las enfermedades cerebrovasculares en la población adulta española.

Pacientes y métodos

Estudio transversal descriptivo de base poblacional. Se calcularon los años de vida ajustados por discapacidad (AVAD) utilizando datos específicos nacionales procedentes de estadísticas y estudios epidemiológicos para obtener resultados representativos a nivel nacional. Los AVAD fueron divididos en años de vida perdidos (AVP) y años vividos con discapacidad (AVD). Los AVAD fueron estimados para el año 2008 mediante la aplicación de la estructura demográfica por sexo y grupos de edad, la mortalidad por causas específicas, los datos de morbilidad y los nuevos pesos de discapacidad que se proponen en el reciente estudio de la carga global de enfermedades. En el caso base, los AVP y los AVD no fueron descontados ni ponderados por edad. La incertidumbre en torno a los AVAD se examinó mediante análisis de sensibilidad.

Resultados

En España, las enfermedades cerebrovasculares generaron 418.052 AVAD, incluyendo 337.000 (80,6%) AVP y 81.052 (19,4%) AVD. Esto representa 1.113 AVAD por 100.000 habitantes (1.197 hombres y 1.033 mujeres) y 3.912 por 100.000 en los mayores de 65 años (4.427 hombres y 2.033 mujeres). En función de la tabla de vida estándar y la elección de las valoraciones sociales utilizadas en los cálculos, los AVAD totales variaron entre un 15,3 y un 59,9% por debajo de los resultados principales.

Conclusiones

Las estimaciones proporcionadas aquí representan un análisis exhaustivo de la carga de las enfermedades cerebrovasculares a nivel nacional. Los programas de prevención y control para reducir la carga de enfermedad cerebrovascular merecen una mayor prioridad en España.

Palabras clave:
Enfermedad cerebrovascular
Ictus
Carga de enfermedad
Años de vida ajustados por discapacidad
España

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