. 2023 Sep;54(9):2380-2389.

doi: 10.1161/STROKEAHA.123.043131. Epub 2023 Jul 27.

Global, Regional, and National Economic Consequences of Stroke

Jakob V E Gerstl^#¹, Sarah E Blitz^#^{1

2}, Qing Rui Qu³, Alexander G Yearley^{1

2}, Philipp Lassarén^{1

4}, Rebecca Lindberg^{1

4}, Saksham Gupta^{1

5}, Ari D Kappel^{1

5}, Juan C Vicenty-Padilla⁶, Edoardo Gaude⁷, Kunakorn C Atchaneeyasakul⁸, Shashvat M Desai⁹, Dileep R Yavagal¹⁰, Luca Peruzzotti-Jametti^{11

12}, Nirav J Patel¹, Mohammed A Aziz-Sultan¹, Rose Du¹, Timothy R Smith¹, Joshua D Bernstock^{1

5

3}

Affiliations

¹ 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.
² Harvard Medical School, Boston, MA (S.E.B., A.G.Y.).
³ David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge (Q.R.Q., J.D.B.).
⁴ Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden (P.L., R.L.).
⁵ Department of Neurosurgery, Boston Children's Hospital (S.G., A.D.K., J.D.B.), Harvard Medical School, MA.
⁶ Department of Neurosurgery, San Jorge Children & Women's Hospital, Santurce, PR (J.C.V.-P.).
⁷ Pockit Diagnostics Ltd., Cambridge, United Kingdom (E.G.).
⁸ Mission Thrombectomy - Global Access for Stroke Treatment (K.C.A.).
⁹ HonorHealth Research and Innovation Institute, AZ (S.M.D.).
¹⁰ Department of Neurology, University of Miami & Jackson Memorial Hospitals, FL (D.R.Y.).
¹¹ Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom (L.P.-J.).
¹² Department of Metabolism, Digestion and Reproduction, Imperial College London (L.P.-J.).

^# Contributed equally.

PMID: 37497672
PMCID: PMC7614992
DOI: 10.1161/STROKEAHA.123.043131

Global, Regional, and National Economic Consequences of Stroke

Jakob V E Gerstl et al. Stroke. 2023 Sep.

. 2023 Sep;54(9):2380-2389.

doi: 10.1161/STROKEAHA.123.043131. Epub 2023 Jul 27.

Authors

Affiliations

¹ 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.
² Harvard Medical School, Boston, MA (S.E.B., A.G.Y.).
³ David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge (Q.R.Q., J.D.B.).
⁴ Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden (P.L., R.L.).
⁵ Department of Neurosurgery, Boston Children's Hospital (S.G., A.D.K., J.D.B.), Harvard Medical School, MA.
⁶ Department of Neurosurgery, San Jorge Children & Women's Hospital, Santurce, PR (J.C.V.-P.).
⁷ Pockit Diagnostics Ltd., Cambridge, United Kingdom (E.G.).
⁸ Mission Thrombectomy - Global Access for Stroke Treatment (K.C.A.).
⁹ HonorHealth Research and Innovation Institute, AZ (S.M.D.).
¹⁰ Department of Neurology, University of Miami & Jackson Memorial Hospitals, FL (D.R.Y.).
¹¹ Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom (L.P.-J.).
¹² Department of Metabolism, Digestion and Reproduction, Imperial College London (L.P.-J.).

^# Contributed equally.

PMID: 37497672
PMCID: PMC7614992
DOI: 10.1161/STROKEAHA.123.043131

Abstract

Background: 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.

Methods: 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.

Results: 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%).

Conclusions: 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.

Keywords: disability-adjusted life years; global health; health economics; stroke.

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Conflict of interest statement

Disclosures Q.R. Qu reports employment by Brigham and Women’s Hospital; Dr Gaude reports stock holdings in Pockit diagnostics; Dr Atchaneeyasakul reports employment by Gravity Medical Technology; Dr Yavagal reports stock options in Rapid Medical, compensation from Vascular Dynamics for consultant services, compensation from Poseydon for consultant services, stock holdings in Athersys, compensation from Johnson & Johnson Health Care Systems, Inc for consultant services, compensation from Stryker Corporation for consultant services, stock options in Poseydon, compensation from Medtronic, United States, Inc for consultant services, compensation from Athersys for consultant services, and compensation from Gravity Medical Technology for consultant services; Dr Aziz-Sultan reports compensation from MicroVention, Inc for other services; Dr Du reports compensation from Grand Rounds for consultant services, employment by Brigham and Women’s Hospital, compensation from Society of Neurological Surgeons for other services, compensation from Oakstone for other services, and compensation from National Institutes of Health for other services; Dr Smith reports stock holdings in Phebe Health; Dr Bernstock has equity positions in POCKiT Diagnostics, which is developing a diagnostic tool for large vessel occlusion detection, he also holds positions/equity in Treovir, NeuroX1, and Centile Bioscience.”

Figures

**Figure 1. VLW/GDP in 2019 by GBD super-region for stroke overall, ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.**
VLW = Value of Lost Welfare, GDP = Gross Domestic Product.

**Figure 2. World heat maps of VLW/GDP in 2019 by country for stroke overall, ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.**
VLW = Value of Lost Welfare, GDP = Gross Domestic Product.

See this image and copyright information in PMC

References

1. Collaborators GS. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795–820. doi: 10.1016/S1474-4422(21)00252-0. - DOI - PMC - PubMed
1. Zhong W, Geng N, Wang P, Li Z, Cao L. Prevalence, causes and risk factors of hospital readmissions after acute stroke and transient ischemic attack: a systematic review and meta-analysis. Neurol Sci. 2016;37:1195–1202. doi: 10.1007/s10072-016-2570-5. - DOI - PubMed
1. Rajsic S, Gothe H, Borba HH, Sroczynski G, Vujicic J, Toell T, Siebert U. Economic burden of stroke: a systematic review on post-stroke care. Eur J Health Econ. 2019;20:107–134. doi: 10.1007/s10198-018-0984-0. - DOI - PubMed
1. Prabhakaran D, Anand S, Gaziano TA, Mbanya JC, Wu Y, Nugent R, editors. Cardiovascular, Respiratory, and Related Disorders. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017. © 2017 International Bank for Reconstruction and Development / The World Bank. - PubMed
1. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, Bustreo F, Evans D, Feachem RG, Frenk J. Global health 2035: a world converging within a generation. The lancet. 2013;382:1898–1955. - PubMed

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Global, Regional, and National Economic Consequences of Stroke

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Global, Regional, and National Economic Consequences of Stroke

Authors

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Abstract

Conflict of interest statement

Figures

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MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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