PCV112 ISCHEMIC STROKE IN KOREA; ESTIMATION OF LIFETIME RISK, LIFE EXPECTANCY, QUALITY-ADJUSTED LIFE EXPECTANCY AND LIFETIME COST

Stroke not only results in major mortality but also morbidity affecting quality of life (QOL) of survivors. This study aimed to investigate impact of ischemic stroke (IS) in Korea by estimating lifetime risk, life expectancy (LE), quality-adjusted life expectancy (QALE), and lifetime cost after the diagnosis of IS. This study included patients (n=10,282) diagnosed with IS (ICD-10, I63.x) between 2006 and 2015 from the national sample cohort of National Health Insurance Service (NHIS) of Korea. Lifetime risk was estimated by cumulative incidence rate (CIR18-84). Lifetime survival of index cohort was obtained through Kaplan-Meier method up to 119 months then extrapolated to 780 months with a semi-parametric method, of which we simulated age-, sex-, and calendar year-matched referents from the national life tables of Korea. QALE was estimated by combining the survival data with repeated measures of QOL results obtained from Korea Health Panel (n=218) with kernel-smoothing method. The lifetime expenditures paid by the NHIS and patients were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime after adjusting for annual discount rates. Lifetime risk of IS showed a decreasing trend in men and women over the 10-year observation period (CIR18-84 19.5% to 15%, 16.1% to 9.9% respectively). Patients with IS were estimated to lose 4.7 life years and 6.5 quality-adjusted life years compared with those of the age- and sex-matched referents. Expected lifetime cost covered by the NHIS would be about 46,100-48,500 USD, and 10,600-11,200 USD for patients and their families. This study has quantified how many life years, quality-adjusted life years and financial expenses could be saved by prevention of IS in Korea. Further studies are warranted to be integrated with functional disability and productivity in order to assess the social impact of stroke.