番茄社区

In-hospital cardiac arrest (IHCA) was a leading cause of annual disability-adjusted life years lost among U.S. adults in 2018, a researcher reported.

IHCA was responsible for 727 disability-adjusted life years (DALY) lost per 100,000 population, placing it 12th, in between road injuries and headache disorders, according to Ryan Coute, DO, of the Heersink School of Medicine at the University of Alabama at Birmingham.

Sudden cardiac arrest (SCA) in total, including IHCA and out-of-hospital cardiac arrest (OHCA), added up to 2,049 DALY per 100,000, putting it just one spot behind ischemic heart disease, according to findings presented at the American College of Emergency Physicians (ACEP) annual meeting.

Three-quarters of the study population died because of SCA, Coute noted.

The data demonstrate that cardiac arrest needs more attention publicly, Coute told 番茄社区. "These results should inform key policymakers, funding agencies, and the public of the significant burden of disease associated with cardiac arrest, and help allocate limited resources to maximally improve public health," Coute and colleagues stated in the presentation.

Metrics such as DALY have not traditionally been used to assess SCA, Coute pointed out.

He said this was the first national study on the impact of IHCA on DALY, following by his group, which found OHCA alone was the third leading cause of DALY in 2016. In 2018, OHCA was sixth on the list at 1,322 DALY lost per 100,000.

For the current retrospective analysis, the researchers examined data from 310 hospitals participating in the national database for 2018. Using the annual bed-days that year for all U.S. hospitals, results were extrapolated to a national level.

Database patients with missing information on age, gender, race, survival status, or neurologic outcome were excluded, according to the researchers.

They calculated DALY by adding years lived with a disability (YLD) to years of life lost (YLL). Patients who experienced more than one SCA of any variety were counted as having one SCA for the database.

YLD represented the prevalence of survivors multiplied by disability weight based on neurologic outcome ( score) at hospital discharge. YLL was calculated by multiplying IHCA deaths by the remaining life expectancy at the time of death. Life expectancy data came from the 2018 National Vital Statistics Report. "Disability weights were based on cardiac arrest data from Israel," Coute's group wrote.

They compared their data to the Global Burden of Disease (GBD) study's top 10 DALY causes in the U.S. They used the largest database available to them, Coute said, which represented about one-seventh of U.S. hospital beds.

One key limitation of the study was that IHCA overlaps with the DALY of other GBD diseases.

The researchers are now evaluating pediatric OHCA data from the same source, Coute reported, and he said he expects the overall SCA burden on DALY in that population to be more intense.

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