Department of Neurosurgery, Brigham and Women's Hospital (J.V.E.G., S.E.B., A.G.Y., P.L., R.L., S.G., A.D.K., N.J.P., M.A.A.-S., R.D., T.R.S., J.D.B.), Harvard Medical School, MA.
Harvard Medical School, Boston, MA (S.E.B., A.G.Y.).
Stroke. 2023 Sep;54(9):2380-2389. doi: 10.1161/STROKEAHA.123.043131. Epub 2023 Jul 27.
An understanding of global, regional, and national macroeconomic losses caused by stroke is important for allocation of clinical and research resources. The authors investigated the macroeconomic consequences of stroke disease burden in the year 2019 in 173 countries.
Disability-adjusted life year data for overall stroke and its subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) were collected from the GBD study (Global Burden of Disease) 2019 database. Gross domestic product (GDP, adjusted for purchasing power parity [PPP]) data were collected from the World Bank; GDP and disability-adjusted life year data were combined to estimate macroeconomic losses using a value of lost welfare (VLW) approach. All results are presented in 2017 international US dollars adjusted for PPP.
Globally, in 2019, VLW due to stroke was $2059.67 billion or 1.66% of the global GDP. Global VLW/GDP for stroke subtypes was 0.78% (VLW=$964.51 billion) for ischemic stroke, 0.71% (VLW=$882.81 billion) for intracerebral hemorrhage, and 0.17% (VLW=$212.36 billion) for subarachnoid hemorrhage. The Central European, Eastern European, and Central Asian GBD super-region reported the highest VLW/GDP for stroke overall (3.01%), ischemic stroke (1.86%), and for subarachnoid hemorrhage (0.26%). The Southeast Asian, East Asian, and Oceanian GBD super-region reported the highest VLW/GDP for intracerebral hemorrhage (1.48%).
The global macroeconomic consequences related to stroke are vast even when considering stroke subtypes. The present quantification may be leveraged to help justify increased spending of finite resources on stroke in an effort to improve outcomes for patients with stroke globally.
了解全球、地区和国家因卒中造成的宏观经济损失对于临床和研究资源的分配非常重要。作者研究了 2019 年 173 个国家卒中疾病负担的宏观经济后果。
从全球疾病负担研究（GBD）2019 数据库中收集了全因卒中及其亚型（缺血性卒中和脑出血）的残疾调整生命年数据。国内生产总值（GDP，经购买力平价调整）数据来自世界银行；将 GDP 和残疾调整生命年数据相结合，使用福利损失价值（VLW）方法来估算宏观经济损失。所有结果均以 2017 年经购买力平价调整的国际美元表示。
在全球范围内，2019 年卒中导致的 VLW 为 20596.7 亿美元，占全球 GDP 的 1.66%。全球各卒中亚型的 VLW/GDP 为：缺血性卒中 0.78%（VLW=9645.1 亿美元），脑出血 0.71%（VLW=8828.1 亿美元），蛛网膜下腔出血 0.17%（VLW=2123.6 亿美元）。中欧、东欧和中亚 GBD 超级区域报告的总体卒中、缺血性卒中和蛛网膜下腔出血的 VLW/GDP 最高（3.01%、1.86%和 0.26%）。东南亚、东亚和大洋洲 GBD 超级区域报告的脑出血 VLW/GDP 最高（1.48%）。
即使考虑到卒中亚型，与卒中相关的全球宏观经济后果也是巨大的。本研究的量化结果可能有助于证明在全球范围内增加对卒中的有限资源投入是合理的，以改善全球卒中患者的预后。
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