Years of disability-adjusted life gained as a result of thrombolytic therapy for acute ischemic stroke

Stroke; a Journal of Cerebral Circulation
Keun-Sik Hong, Jeffrey L Saver

Abstract

Disability-adjusted life year (DALY) metric reflects years of healthy life lost because of living with disability and years of life lost because of premature mortality. Widely used in epidemiological analyses, DALY has not been applied to acute stroke trials. From previous studies, we derived, for each modified Rankin Scale level, disability weights, disability-linked mortality hazard ratios, and age-specific life expectancies. We then analyzed patient level data from the 2 publicly available National Institute of Neurological Disorders and Stroke (NINDS) recombinant tissue plasminogen activator trials. For each subject, we abstracted age, treatment assignment, and 3-month modified Rankin Scale outcome and calculated the DALYs lost resulting from the qualifying stroke. The disability-linked hazard ratios for premature annual mortality for a modified Rankin Scale score of 0 to 5 were 1.53, 1.52, 2.17, 3.18, 4.55, and 6.55, respectively. In the NINDS recombinant tissue plasminogen activator trials, DALYs (mean+/-SE) lost as a result of the qualifying stroke were substantially less with recombinant tissue plasminogen activator than with placebo (4.64+/-0.17 versus 5.91+/-0.21; P<0.0001), a finding that remained robust after adjust...Continue Reading

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Citations

Jul 20, 2010·Nature Reviews. Neurology·Susan C Fagan
Jul 3, 2010·Stroke; a Journal of Cerebral Circulation·Keun-Sik HongByung-Chul Lee
Apr 30, 2011·Stroke; a Journal of Cerebral Circulation·Keun-Sik HongJeffrey L Saver
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