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332907
Disease burden and attributable risk factors of stroke in Taiwan, 2007 to 2012


Monday, November 2, 2015 : 3:42 p.m. - 4:00 p.m.

Yun-Chun Wu, MS, Institute of Epidemiology and Preventive Medicine, College of public health, National Taiwan University, Taipei, Taiwan
Wei-Cheng Lo, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan
Chung-Yi Hsu, China Medical University, Taichung, Taiwan
Kuo-Liong Chien, National Taiwan University, Taipei, Taiwan
Pei-Chun Chen, Chang Gung University, Tao-Yuan, Taiwan
Hsien-Ho Lin, MD, ScD, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan
Audio (mp3) recording Recorded Presentation (mp4)
Background: Stroke is the third leading cause of death in Taiwan. Comprehensive assessment of stroke epidemiology in terms of disease burden and attributable risk factors is essential for the design and implementation of effective intervention strategies. We estimated the disease burden of stroke from 2007 to 2012 and the attributable burden due to selected modifiable risk factors.

Method: We estimated the disability-adjusted life years (DALYs) by calculating the loss from premature death (years of life lost, YLLs) and the loss due to nonfatal disabling condition (years lived with disability, YLDs). We used the National Health Insurance Research Database (NHIRD), Taiwan Stroke Registry, and National Death Registry dataset to calculate DALYs lost by sex, age groups, and subtypes of stroke from 2007 to 2012. We applied the comparative risk assessment framework to investigate the disease burden of stroke attributable to physiological, lifestyle, and environmental risk factors.

Result: From 2007 to 2012, the prevalence of stroke increased from 0.57% to 1.44%, and stroke mortality decreased from 0.04% to 0.006%. In 2012, there were 58,238 prevalent cases of stroke and 11,061 deaths due to stroke. During 2007-2012, the crude YLDs increased from 40,135 to 98,395, while the crude YLLs decreased from 181,581 to 147,536, and the crude DALYs remained relatively unchanged (221,716 in 2007 and 245,932 in 2012). We found that 20.9% of deaths from stroke, and 47.8% of DALYs lost because of stroke were in people younger than 65 years. Major risk factors that accounted for the DALY loss due to stroke were high blood pressure contributed 71,750 DALYs (95% CI: 50,860–92,650), ambient particulate matter pollution (48,600 DALYs, 95% CI: 24,610–72,590), physical inactivity (49,060 DALYs, 95% CI: 40,850–57,280), high BMI (44,040 DALYs, 95% CI: 31,160–56,920), high blood glucose (34,250 DALYs, 95% CI: 12,970–55,540), and smoking (30,190 DALYs, 95% CI: 14,980–45,390). 

Conclusion: During 2007-2012, the mortality of stroke has decreased in Taiwan, but the prevalence has increased. Overall the disease burden from stroke remained high. To reduce the disease burden, a multifaceted approach including reducing physiological risk factors, promoting healthy lifestyle, and intervening on ambient air pollution will be needed.


Learning Areas:

Chronic disease management and prevention
Epidemiology
Public health or related public policy

Learning Objectives:
Identify the disease burden and attributable risk factors of stroke in Taiwan.

Keyword(s): Disabilities, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student supervised by Dr. Hsien-Ho Lin who is a well-funded epidemiologist with amount of research experience in chronic disease prevention. My research focuses on studying burden of disease and disability distribution in Taiwan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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