Paratz Elizabeth D, Smith Karen, Ball Jocasta, van Heusden Alexander, Zentner Dominica, Parsons Sarah, Morgan Natalie, Thompson Tina, James Paul, Pflaumer Andreas, Semsarian Christopher, Stub Dion, Liew Danny, La Gerche Andre
Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC, 3065, Australia.
Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Paramedicine, Monash University, Melbourne, VIC, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia.
Resuscitation. 2021 Apr 15;163:49-56. doi: 10.1016/j.resuscitation.2021.04.001.
There are 20,000 sudden cardiac arrests (SCAs) in Australia annually, with 90% case-fatality.
The present study calculated both the health and economic impact of SCAs in Victoria, Australia.
Data on all SCAs attended by Ambulance Victoria from July 2017 to June 2018 were collected regarding age, gender, and survival to hospital, discharge and 12 months. Pre-SCA employment status of all patients was modelled using age and gender-matched Australian economic data. A Markov state-transition model with a five-year horizon calculated health and economic impact in years of life lived (YLL), productivity-adjusted life years (PALYs) and gross domestic product (GDP) lost. A counterfactual Markov state-transition model assessed outcomes of an identical cohort of patients who did not experience SCA. All values were discounted by 5%.
In 12 months, 4637 people suffered SCAs in Victoria, of whom 1516 (32.7%) were working at the time. 695 patients (15.0%) survived to hospital, 325 (7.0%) to discharge, and 303 (6.5%) to 12 months. In five years following their SCA, the cohort lost 15,922 years of life and 2327 PALYs. Reduced productivity led to GDP losses of AUD$448 million (92.8% relative reduction). Extrapolated to the 20,000 SCAs occurring across all of Australia, total GDP losses approached AUD$2 billion.
The health and economic burden of SCAs is high, predominantly underpinned by very high mortality. Annual national losses approach AUD$2 billion (USD$1.42 billion) and are comparable to productivity losses from all cancers combined. Prioritising research and state-of-the-art care for SCA patients appears economically sound.
澳大利亚每年有20000例心搏骤停（SCA），病死率达90%。
本研究计算了澳大利亚维多利亚州心搏骤停对健康和经济的影响。
收集了2017年7月至2018年6月期间维多利亚州救护车服务中心接诊的所有心搏骤停患者的年龄、性别以及存活至入院、出院和12个月的数据。利用年龄和性别匹配的澳大利亚经济数据对所有患者心搏骤停前的就业状况进行建模。采用一个为期五年的马尔可夫状态转换模型计算生命年损失（YLL）、生产力调整生命年（PALY）和国内生产总值（GDP）损失方面的健康和经济影响。一个反事实马尔可夫状态转换模型评估了未经历心搏骤停的相同患者队列的结局。所有数值均按5%进行贴现。
在12个月内，维多利亚州有4637人发生心搏骤停，其中1516人（32.7%）当时正在工作。695例患者（15.0%）存活至入院，325例（7.0%）存活至出院，303例（6.5%）存活至12个月。在心搏骤停后的五年里，该队列损失了15922个生命年和2327个生产力调整生命年。生产力下降导致GDP损失4.48亿澳元（相对下降92.8%）。推算至全澳大利亚发生的20000例心搏骤停，GDP总损失接近20亿澳元。
心搏骤停的健康和经济负担很重，主要是由极高的死亡率所致。每年全国损失接近20亿澳元（14.2亿美元），与所有癌症合计造成的生产力损失相当。优先开展针对心搏骤停患者的研究和提供最先进的治疗在经济上似乎是合理的。
