The impact of stroke in Italy: First step for a National Burden of Disease Study

Purpose: To calculate the impact of stroke in Italy in 1998, expressed in terms of disability adjusted life years (DALYs) according to the WHO Global Burden of Disease (GBD) Study. Method: 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, were used to compute the years of life lived with disability (YLDs), which were added to the years of life lost due to premature mortality (YLLs), calculated from stroke mortality data, to obtain the DALYs. The results were extrapolated to the rest of Italy after examination of national stroke registries data. Results: Standardized estimated incidence of FES in FVG in 1998 was lower ( 135 cases of FES per 100 000 inhabitants) than that reported in other published national and international studies. Estimated case fatality rate and distribution of post-FES disability did not differ from other similar studies. About 100 000 YLLs and 273 000 YLDs due to FES were estimated in 1998 for Italy. Conclusions: The estimated proportion of the YLDs on total DALYs (27%) is comparable with that obtained in the EURO-A group ( the European area including Italy) of the GBD 2000 Study (31%), and the Australian BoD Study (35%).