[Estimating disability-adjusted life-years for subtypes of acute ischemic stroke]

Objective To test the hypothesis that DALYs, estimated individually for each patient with acute ischemic stroke upon hospital discharge, without reperfusion therapy, are not different between the different subtypes of ischemic stroke. Patients and Methods In the Hospital Universitario de la Samaritana in Bogotá, the health records of patients diagnosed with their first acute ischemic stroke event from admission and monitoring to discharge were selected. The subtype of acute ischemic stroke was classified according to the criteria established by the Trial of Org 10172 in Acute Stroke Treatment (TOAST). DALYs were estimated for each patient with acute ischemic stroke at hospital discharge. To establish differences of DALYs among the five acute ischemic stroke subtypes (TOAST), the Kruskal Wallis test was used. Results Of the 39 cases of acute ischemic stroke, 17 (43.6 %) were classified as artherosclerosis, 10 (25.6 %) as lacunar events, 6 (15.4 %) as cardioembolic attacks, and another 6 (15.4 %) cases with unclear etiology. At hospital discharge, the estimated total DALYs provided by patients with acute ischemic stroke was 316.9 years, without statistically significant differences between the subtypes of ischemic stroke. At hospital discharge, the average of optimal years free of disability lost by a patient surviving an acute ischemic stroke was 8.12. Conclusion Non conclusive results are attributed to the concurrence of dissimilar acute clinical care processes and to the risk factors distributions, comorbidities and patient complications.