Abstract
BACKGROUND AND OBJECTIVE: Stroke is a leading cause of death and disability worldwide. The age of stroke cases is decreasing, resulting in a loss of productivity for patients and their informal caregivers. However, socioeconomic impact analyses of stroke often underestimate the importance of these indirect costs. The objective was to conduct a systematic review of indirect costs associated with lost productivity after stroke to highlight their relevance. METHODS: A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched for scientific publications analyzing loss of work productivity during first post-stroke year. To perform the comparative analysis, the type of stroke was taken into account in relation to the type of productivity loss and the age of the patients. The risk of bias was assessed with Consolidated Health Economic Evaluation Reporting Standards (CHEERS). RESULTS: A total of 928 records were identified, of which 24 were included in this review. Lost productivity of patient during the first year after stroke onset had a mean value of $6057.98, representing 35.1% of total cost during this period. Patient´s lost productivity was higher in hemorrhagic stroke compared to ischemic stroke ($12,783.17 vs. $8,239.34). In contrast, lost productivity of informal caregivers was slightly higher in ischemic stroke than in hemorrhagic stroke ($5,628.26 vs. $4,205.25). Patients aged 18–44 years had the highest work productivity loss ($16,114.33). CONCLUSIONS: Indirect costs represent a significant part of the economic burden of stroke and should therefore be included in future socioeconomic impact studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-026-00727-x.