Future burden of ischemic stroke in Australia: impact on health outcomes between 2019 and 2038.

BACKGROUND: Projections of the future burden of ischemic stroke (IS) has not been extensively reported for the Australian population; the availability of such data would assist in health policy planning, clinical guideline updates, and public health.

METHODS: First, we estimated the lifetime risk of IS (from age 40 to 100 years) using a multi-state life table model. Second, a multistate dynamic model was constructed to project the burden of IS for the whole Australian population aged between 40 and 100 years over a twenty-year period (2019-2038). Data for the study were primarily sourced from a large, representative Victorian linked dataset based on the Victorian Admitted Episode Dataset and National Death Index. The model projected prevalent and incident cases of non-fatal IS and fatal-IS, and years of life lived (YLL) with and without IS. The YLL outcome was discounted by 5% annually; we varied the discounting rate in scenario analyses.

RESULTS: The lifetime risk of IS from age 40 years was estimated as 15.5% for males and 14.0% for females in 2018. From 2019-2038, 644 208 Australians were projected to develop incident IS (564 922 non-fatal and 79 287 fatal). By 2038, the model projected there would be 358 534 people with prevalent IS, and in 2038 there would be 35 554 incident non-fatal IS and 5 338 incident fatal-IS, a 14.2% (44 535), 72.9% (14 988) and 106.3% (2 751) increase compared to 2019 estimations, respectively. Projected YLL (with a 5% discount rate) accrued by the Australian population were 174 782 672 (84 251 360 in males and 90 531 312 in females), with 4 053 794 YLL among people with IS (2 320 513 in males, 1 733 281 in females).

CONCLUSION: The burden of IS was projected to increase between 2019 to 2038 in Australia. The outcomes of the model provide important information for decision-makers to design strategies to reduce stroke burden.