title: The national burden of cerebrovascular diseases in Spain: a population-based study using disability-adjusted life years.
abstract: OBJECTIVE
  The aim of the present study was to determine the national burden of cerebrovascular diseases in the adult population of Spain.
  
  
  METHODS
  Cross-sectional, descriptive population-based study. We calculated the disability-adjusted life years (DALY) metric using country-specific data from national statistics and epidemiological studies to obtain representative outcomes for the Spanish population. DALYs were divided into years of life lost due to premature mortality (YLLs) and years of life lived with disability (YLDs). DALYs were estimated for the year 2008 by applying demographic structure by sex and age-groups, cause-specific mortality, morbidity data and new disability weights proposed in the recent Global Burden of Disease study. In the base case, neither YLLs nor YLDs were discounted or age-weighted. Uncertainty around DALYs was tested using sensitivity analyses.
  
  
  RESULTS
  In Spain, cerebrovascular diseases generated 418,052 DALYs, comprising 337,000 (80.6%) YLLs and 81,052 (19.4%) YLDs. This accounts for 1,113 DALYs per 100,000 population (men: 1,197 and women: 1,033) and 3,912 per 100,000 in those over the age of 65 years (men: 4,427 and women: 2,033). Depending on the standard life table and choice of social values used for calculation, total DALYs varied by 15.3% and 59.9% below the main estimate.
  
  
  CONCLUSIONS
  Estimates provided here represent a comprehensive analysis of the burden of cerebrovascular diseases at a national level. Prevention and control programmes aimed at reducing the disease burden merit further priority in Spain.
authors.affiliation: Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Madrid, Spain; Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain. Electronic address: ferran_catala@hotmail.com.
authors.forename: Ferrán
authors.initials: F
authors.lastname: Catalá-López
authors.affiliation: Health Research, Training and Infrastructures General Directorate, Regional Health Council, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Fernández de Larrea-Baz
authors.affiliation: Unidad Docente de Medicina Familiar y Comunitaria Este, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Morant-Ginestar
authors.affiliation: Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Álvarez-Martín
authors.affiliation: Stroke Unit, Neurology Department, 12 de Octubre University Hospital, Faculty of Medicine, Complutense University, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Díaz-Guzmán
authors.affiliation: Primary Care General Directorate, Regional Health Council, Madrid, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Gènova-Maleras
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Años de vida ajustados por discapacidad; Burden of disease; Carga de enfermedad; Cerebrovascular disease; Disability-adjusted life years; Enfermedad cerebrovascular; España; Ictus; Spain; Stroke