Advertisement

Disability-Adjusted Life Years, Years of Life Lived with Disability, and Years of Life Lost in Stroke: Italian Perspectives

  • S. Mariotti
Reference work entry

Abstract:

This chapter evaluates the impact of  stroke in Italy in 1999, expressed in terms of disability adjusted life years ( DALYs) using mostly the methods developed by WHO in the Global Burden of Disease (GBD) Study. For mortality, the official mortality data for Italy from ISTAT (Italian National Statistical Institute) was used. For disability, the data on first-ever stroke incidence (FES), remission rate and case fatality derived from the health information system and a research on post-FES disability of the Friuli Venezia-Giulia (FVG) region and similar data from the Tuscany region and from the province of Verona in the Veneto region were used and pooled.

Both the mortality and disability aspects of the impact of stroke are taken into account and  YLLs (years of life lost) and  YLDs (years of life lived with disability) respectively are calculated and then summed to obtain the DALYs. To calculate the YLDs, several epidemiological quantities are estimated by sex and age class and for each of the three areas considered in the study. A mean of the pooled data was used to extrapolate the results to the whole Italy.

About 258,000 YLLs and 153,000 YLDs due to FES were estimated in 1999 for Italy. The results in terms of YLLs, YLDs and DALYs were compared with other studies for which detailed results were available, relative to populations with similar characteristics of development: YLD rates per 100,000 people were similar in Italy to the values obtained in the US BOD study both for men (228 vs. 244) and women (308 vs. 301), but values considerably lower were obtained in the Australian BOD study (175 for men and 118 for women). In terms of DALYs rates per 100,000 people, Italy (723) is more similar to the EURO-A group (the European area including Italy) of the GBD study (671) than to the US (569) or Australia (435), because YLLs in Italy are higher than in those other areas.

Keywords

Cerebrovascular Disease Stroke Survivor Functional Independence Measure Stroke Incidence Disability Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

BOD

Burden of Disease

DALY(s)

Disability Adjusted Life Years

GBD

Global Burden of Disease

EURO-A

(a group of 26 economically developed European countries)

FES

First-Ever Stroke

MONICA

MONItoring of trends and determinants in CArdiovascular disease

ICD

International Classification of Diseases

ISTAT

Italian National Statistical Institute

TIA

Transient Ischemic Attack

WHO

World Health Organization

FVG

Friuli Venezia-Giulia

YLD(s)

Years of life Lived with Disability

YLL(s)

Years of Life Lost

Notes

Acknowledgements

This study was made possible by two grants from the Italian Ministry of Health. The author acknowledges also the important contributions of ideas and work by Dr. Antonella Franzo, Dr. Carlo Francescutti, Dr. Giorgio Simon and Dr. Rossella Di Bidino, co-authors together with Dr. Sergio Mariotti of other papers treating similar subjects.

References

  1. Anderson C, Jamrozik KF, Broadhurst RF, Stewart-Wynne EG. (1994). Stroke. 25(10): 1935–1944.PubMedGoogle Scholar
  2. Bonita R, Solomon N, Broad JB. (1997). Stroke. 28: 1898–1902.PubMedGoogle Scholar
  3. Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO. (1996). Stroke. 27: 373–380.PubMedGoogle Scholar
  4. Carolei A, Marini C, Di Napoli M. (1997). Stroke. 28: 2500–2505.PubMedGoogle Scholar
  5. D’Alessandro G, Di Giovanni M. (1992). Stroke. 23: 1712–1715.PubMedGoogle Scholar
  6. D’Alessandro G, Bottacchi E, Di Giovanni M, Martinazzo C, Sironi L, Lia C, et al. (2000). Neurol. Sci. 21: 13–18.PubMedCrossRefGoogle Scholar
  7. Dennis MS, Burn JPS, Sandercock PAG, Bamford JM, Wade DT, Warlow CP. (1993). Stroke. 24: 796–800.PubMedGoogle Scholar
  8. Di Carlo A, Baldereschi M, Gandolfo C, et al. (2003a). Cerebrovasc Dis. 16: 141–150.PubMedCrossRefGoogle Scholar
  9. Di Carlo A, Inzitari D, Galati F, et al. (2003b). Cerebrovasc Dis. 16: 410–417.PubMedCrossRefGoogle Scholar
  10. Francescutti C, Mariotti S, Simon G, D’Errigo P, Di Bidino R. (2005). Disability and Rehabilitation, 27(5): 229–240.Google Scholar
  11. Giroud M, Beuriat P, Vion P, D’Athis PH, Dusserre L, Dumas R. (1989). Neuroepidemiology. 8: 97–104.PubMedCrossRefGoogle Scholar
  12. Keith RA, Granger C, Hamilton BB, Sherwin FS. (1987). Adv Clin Rehabil. 1: 6–18.PubMedGoogle Scholar
  13. Lauria G, Gentile M, Fassetta G, Casetta I, Agnoli F, Andreotta G, et al. (1995). Stroke. 26: 1787–1793.PubMedGoogle Scholar
  14. Linacre JM, Heinemann AW, Wright BD, Granger CV, Hamilton BB. (1994). Arch Phys Med Rehabil 75: 127–132.PubMedGoogle Scholar
  15. Lopez AD, Mathers CD, Majid Ezzati, Dean T, Jamison, Christopher J. Murray L. (eds.) (2006). Global Burden of Disease and Risk Factors. Oxford University Press, New York.CrossRefGoogle Scholar
  16. Malmgren R, Warlow C, Bamford J, and Sandercock P. (1987). Lancet 2(8569): 1196–1200.PubMedCrossRefGoogle Scholar
  17. Marini C, Triggiani L, Cimini N, Ciancarelli I, De Santis F, Russo T, Baldassarre M, di Orio F, Carolei A. (2001). Neuroepidemiology 20: 91–95.PubMedCrossRefGoogle Scholar
  18. Mariotti S, D’Errigo P, Mastroeni S, Freeman K. (2003). Eur J Epidemiol. 18: 513–521.PubMedCrossRefGoogle Scholar
  19. Mathers C, Vos T, Stevenson C. (1999). The Burden of Disease and Injury in Australia. Australian Institute of Health and Welfare (AIHW), Canberra. Also available on the worldwide web at www.aihw.gov.au
  20. Mathers CD, Vos T, Lopez AD, et al. (ed.). (2001). National Burden of Disease Studies: a Practical Guide. edn 2.0. Global Program on Evidence for Health Policy. World Health Organization, Geneva.Google Scholar
  21. McGovern PG, Pankow JS, Burke GL, Shahar E, Sprafka JM, Folsom AR, Blackburn H. (1993). Stroke. 24: 1640–1648.PubMedGoogle Scholar
  22. Melse JM, Essink-Bot ML, Kramers PG, Hoeymans N. (2000). Am J Public Health. 90: 1241–1247.PubMedCrossRefGoogle Scholar
  23. Michaud CM, McKenna MT, Begg S, et al. (2006). Popul Health Metr. 4: 11.PubMedCrossRefGoogle Scholar
  24. Murray CJ, Lopez AD, Mathers CD, Stein C. (2001). The Global Burden of Disease 2000 Project: Aims, Methods and Data Sources. WHO, Geneva (Global Program on Evidence for Health Policy, Discussion Paper).Google Scholar
  25. Murray CJ, Lopez AD (eds.). (1996). The Global Burden of Disease: a Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Global Burden of Disease and Injury series vol. 1. Harvard University Press, Harvard.Google Scholar
  26. Orgogozo JM. (1994). Cerebrovasc Dis. 4(suppl 2): 2–6.CrossRefGoogle Scholar
  27. Ricci S, Celani MG, La Rosa F, et al. (1991). J Neurol Neurosurg Psychiatry. 54: 695–698.PubMedCrossRefGoogle Scholar
  28. Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, Shea S, et al. (1998). Am J Epidemiol. (JID–7910653) 147: 259–268.Google Scholar
  29. Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J. (2000). Stroke. 31: 1588–1601.PubMedGoogle Scholar
  30. Sarti C, Stegmayr B, Tolonen H, Mahonen M, Tuomilehto J, and for the WHO MONICA Project. (2002). Are Changes in Stroke Mortality Due to Changes in Stroke Attack Rates or Changes in Case Fatality? American Heart Association, TX.Google Scholar
  31. Stegmayr B, Asplund K. (1992). Neuroepidemiology 11: 204–213.PubMedCrossRefGoogle Scholar
  32. Stouthard M, Essink-Bot M, Bonsel G, Barendregt J, Kramers P. (1997). Disability weights for diseases in the Netherlands. Erasmus University. The Netherlands, Rotterdam.Google Scholar
  33. Sudlow CLM, Warlow CP. (1997). Stroke 28: 491–499.PubMedGoogle Scholar
  34. Szczesniewska D, Kurjata P, Broda G, Polakowska M, Kupsc W. (1990). Rev.Epidemiol.Sante Publique 38: 435–439.PubMedGoogle Scholar
  35. Tesio L. (2002). Progetto di sperimentazione gestionale rete informativa sul percorso riabilitativo del paziente con ictus nella Regione Autonoma Friuli Venezia Giulia, So. Ge. Com., Editrice Ricerca in Riabilitazione, Milano.Google Scholar
  36. Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M. (1995). Stroke. 26(3): 361–367.PubMedGoogle Scholar
  37. Truelsen T, Begg S, Mathers C. (2003). The Global Burden of Cerebrovascular Disease. WHO.Google Scholar
  38. Williams A. (1999). Practitioner. 243: 222–225.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • S. Mariotti

There are no affiliations available

Personalised recommendations