Disability-Adjusted Life Years Following Adult Out-of-Hospital Cardiac Arrest in the United States

Abstract

Background Disability-adjusted life years (DALY) are a common public health metric used to consistently estimate and compare health loss because of both fatal and nonfatal disease burden. The annual number of DALY because of adult out-of-hospital cardiac arrest (OHCA) in the United States is unknown. Our objective was to estimate the DALY after adult nontraumatic, emergency medical services–treated OHCA, and to compare OHCA DALY to other leading causes of death and disability in the US. Methods and Results The DALY were calculated as the sum of years of life lost and years lived with disability. The years of life lost were calculated using all adult nontraumatic emergency medical services–treated OHCA with complete data from the national Cardiac Arrest Registry to Enhance Survival database for 2016, and actuarial data for remaining life expectancy at the age of death. Cerebral performance category scores from the Cardiac Arrest Registry to Enhance Survival database and previously established disability weights were used to estimate years lived with disability. The cohort’s calculated DALY were extrapolated to a national level to estimate total US DALY. Data were reported as total, mean, and DALY per 100 000 individuals. A total of 59 752 OHCA met study inclusion criteria. The DALY for the study population were 1 194 993 (years of life lost, 1 194 069; years lived with disability, 924) in 2016. The estimated total DALY following adult nontraumatic emergency medical services–treated OHCA in the US were 4 354 192 (years of life lost, 4 350 825; years lived with disability, 3365) for the index year 2016. The rate of OHCA DALY were 1347 per 100 000 population, which ranked third in the US behind ischemic heart disease (2447) and low back and neck pain (1565). Sensitivity analyses yielded similar findings. Conclusions Adult nontraumatic OHCA is a leading cause of annual DALY in the US and should be a focus of public health policy and resources.

Understanding the lived experiences of short‐ and long‐term consequences on daily life after out‐of‐hospital cardiac arrest. A focus group study

“…The OHCA survival rate is still poor (Myat et al., 2018). In terms of morbidity and accompanying health deficits OHCA is a major public health issue as the disability‐adjusted life years following adult OHCA rank third in the United States (Coute et al., 2019). As an increasing number of lay people are trained in cardiopulmonary resuscitation (CPR), and the number of and the accessibility of automated external defibrillators (AEDs) are increasing, the survival rates might improve in the coming years (Gräsner et al., 2016).…”

The Needs of Families During Cardiac Arrest Care: A Survivor- and Family-led Scoping Review Protocol

“…1 In many jurisdictions, the survival rate after out-of-hospital CA (OHCA) remains lower than 10%, despite half a century of cardiopulmonary resuscitation advocacy, life-support guidelines, and invasive therapies. Given the finality of CA for most of the victims who experience it and the more than 50% of the survivors of CA who face long-term cognitive and/or physical disabilities, [2][3][4][5] it can be argued that the families and loved ones of those who experience CA share in the burden of this disease. [6][7][8][9] However, relatively little is known about the families' perspective on CA.…”

Effectiveness of bystander cardiopulmonary resuscitation in improving the survival and neurological recovery of patients with out-of-hospital cardiac arrest: A nationwide patient cohort study

“…The societal burden of OHCA is comparable to or even greater than that of other leading causes of death [4,5]. A previous study showed that the burden of nontraumatic OHCA in the US was approximately 1,347 disability-adjusted life years per 100,000 population in 2016, ranking third after ischemic heart disease (2,447) and low back and neck pain (1,565) [6].…”