Future burden of ischemic stroke in Australia: impact on health outcomes between 2019 and 2038.

Abstract

BACKGROUND Projections of the future burden of ischemic stroke (IS) has not been extensively reported for the Australian population; the availability of such data would assist in health policy planning, clinical guideline updates, and public health. METHODS First, we estimated the lifetime risk of IS (from age 40 to 100 years) using a multi-state life table model. Second, a multistate dynamic model was constructed to project the burden of IS for the whole Australian population aged between 40 and 100 years over a twenty-year period (2019-2038). Data for the study were primarily sourced from a large, representative Victorian linked dataset based on the Victorian Admitted Episode Dataset and National Death Index. The model projected prevalent and incident cases of non-fatal IS and fatal-IS, and years of life lived (YLL) with and without IS. The YLL outcome was discounted by 5% annually; we varied the discounting rate in scenario analyses. RESULTS The lifetime risk of IS from age 40 years was estimated as 15.5% for males and 14.0% for females in 2018. From 2019-2038, 644 208 Australians were projected to develop incident IS (564 922 non-fatal and 79 287 fatal). By 2038, the model projected there would be 358 534 people with prevalent IS, and in 2038 there would be 35 554 incident non-fatal IS and 5 338 incident fatal-IS, a 14.2% (44 535), 72.9% (14 988) and 106.3% (2 751) increase compared to 2019 estimations, respectively. Projected YLL (with a 5% discount rate) accrued by the Australian population were 174 782 672 (84 251 360 in males and 90 531 312 in females), with 4 053 794 YLL among people with IS (2 320 513 in males, 1 733 281 in females). CONCLUSION The burden of IS was projected to increase between 2019 to 2038 in Australia. The outcomes of the model provide important information for decision-makers to design strategies to reduce stroke burden.