title: Disease burden of stroke in Kolkata, India: derivation of disability-adjusted life years by a direct method.
abstract: OBJECTIVE
  The disability-adjusted life year (DALY) is a new time-based measure of disease burden incorporating both disability and mortality. Our study aims to determine the DALYs lost due to stroke using a direct methodology and the implications.
  
  
  METHODS
  A population-based, house-to-house, 2-stage, prospective study on stroke was conducted over 7 years in Kolkata, India, on 100,802 randomly selected subjects to capture the incident cases of first-ever stroke and those with fatal stroke. The data were utilized to estimate years of life lost due to premature mortality (YLLs), years lived with disability (YLDs) and DALYs lost.
  
  
  RESULTS
  Over 7 years, there were 763 incident cases of first-ever stroke; of these, 320 had a fatal stroke within 30 days and 443 were stroke survivors. The overall DALYs lost due to stroke were computed as 795.57 per 100,000 person-years (730.43 in men and 552.86 in women). The overall YLL and YLD values were 593.14 and 202.43 per 100,000 person-years, respectively. The YLLs comprised 74.5% of the total DALYs.
  
  
  CONCLUSIONS
  This is the first study in India where DALYs lost due to stroke were derived by a direct method. High YLL values demand urgent measures for controlling premature stroke death.
authors.affiliation: Department of Neurology, National Neuroscience Centre, Kolkata, India.
authors.forename: Tapas Kumar
authors.initials: TK
authors.lastname: Banerjee
authors.forename: Saunak
authors.initials: S
authors.lastname: Dutta
authors.forename: Biman Kanti
authors.initials: BK
authors.lastname: Ray
authors.forename: Malay
authors.initials: M
authors.lastname: Ghosal
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.forename: Arijit
authors.initials: A
authors.lastname: Chaudhuri
authors.forename: Shyamal Kumar
authors.initials: SK
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D055815:Young Adult