115EMF Estimating the Public Health Impact of Sudden Cardiac Arrest in the United States

Abstract

Disability-adjusted life years (DALY) are a common public health metric used to estimate and compare the relative burden of one disease to another. The annual number of DALY due to in-hospital cardiac arrest (IHCA) in the United States (US) are unknown. We sought to estimate DALY following adult IHCA, and to compare IHCA DALY to other leading causes of death and disability in the US. The DALY were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). The YLL were calculated using all adult IHCA with complete data from the American Heart Association Get With The Guidelines-Resuscitation database for 2018. Cerebral performance category scores and previously established disability weights were used to estimate YLD for survivors. The cohort’s calculated DALY were extrapolated to a national level to estimate total US DALY, and were compared to a published ranking of the leading causes of DALY in the US for 2018. Data were reported as total and rate (DALY per 100,000 individuals). IHCA DALY were combined with published DALY values for out-of-hospital cardiac arrest (OHCA) to estimate the public health impact of sudden cardiac arrest as a whole (ie, IHCA + OHCA). A total of 21,258 IHCA from 310 hospitals met study inclusion criteria. The DALY for the study population were 313,341 (YLL = 312,678; YLD = 663). The total DALY following adult IHCA in the US were 2,379,536 (YLL = 2,374,501; YLD = 5,035) for 2018. The rate of IHCA DALY were 727 per 100,000 population, which represented the 11th leading cause of DALY in the US in 2018. (FIGURE) When combined with OHCA (1322 per 100,000), sudden cardiac arrest (2,049 per 100,000) was found the be the 2nd leading cause of DALY in the US behind ischemic heart disease (2,681 per 100,000). Sudden cardiac arrest is a leading cause of annual disability-adjusted life years lost in the US and should be a focus of public health policy and resources.