Salem Khal, ElKhateeb Osama
Cardiac Center, King Abdullah Medical City (KAMC), Makkah, Saudi, Arabia.
ESC Heart Fail. 2017 Aug;4(3):259-265. doi: 10.1002/ehf2.12156. Epub 2017 Apr 10.
The two components of disability-adjusted life year (DALY), years of life lost (YLL) and years lived with disability (YLD), are underutilized in evaluating heart failure with reduced ejection fraction (HFrEF) and in assessing the global burden of disease. We aim to describe both the direct (medical) and the indirect (morbidity and mortality) inpatient cost of congestive heart failure in a high-income non-Organization for Economic Cooperation and Development Middle Eastern country in relation to YLL and YLD.
We used the World Health Organization's global burden of disease methodology to calculate DALY, YLL, and YLD in 174 consecutive prospectively enrolled New York Heart Association Classes II-IV patients in a single-centre heart failure registry using a 0.4 disability weight and a 3% future age discount. We reported the cost of hospitalization, re-hospitalization, and non-invasive and invasive procedures per 1000 HFrEF patients in US dollars (USD). Expressing results as per 1000 HFrEF capita revealed a DALY of 1480 ± 1909 vs. 2177 ± 2547 in women and men, respectively. The costs per HFrEF capita in USD were $909.00 ± 676.1 for a single-day hospital stay, $7999 per single hospitalization, $12 311 ± 13 840 for annual hospitalizations, $20 486 ± 22 068 for all-cause hospitalizations, and $37 355 ± 49 336 from the time of diagnosis until death or recovery.
In this study, HFrEF imposed a substantial economic and disability burden on one non-Organization for Economic Cooperation and Development Middle Eastern country. However, men represented a higher economic burden than women.
残疾调整生命年(DALY)的两个组成部分,即生命损失年数(YLL)和残疾生存年数(YLD),在评估射血分数降低的心力衰竭(HFrEF)以及评估全球疾病负担方面未得到充分利用。我们旨在描述一个高收入的非经济合作与发展组织中东国家充血性心力衰竭的直接(医疗)和间接(发病率和死亡率)住院费用与YLL和YLD的关系。
我们使用世界卫生组织的全球疾病负担方法,在一个单中心心力衰竭登记处,对174例连续前瞻性纳入的纽约心脏协会II-IV级患者计算DALY、YLL和YLD,使用0.4的残疾权重和3%的未来年龄贴现率。我们报告了每1000例HFrEF患者的住院、再次住院以及非侵入性和侵入性手术的费用(以美元计)。以每1000例HFrEF人均来表示结果,女性和男性的DALY分别为1480±1909和2177±2547。每例HFrEF人均费用(以美元计)为单日住院909.00±676.1美元、单次住院7999美元、年度住院12311±13840美元、全因住院20486±22068美元,以及从诊断到死亡或康复的费用为37355±49336美元。
在本研究中,HFrEF给一个非经济合作与发展组织中东国家带来了巨大的经济和残疾负担。然而,男性的经济负担高于女性。