Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, United States; Cardiac Arrest Registry to Enhance Survival (CARES) Surveillance Group, Atlanta, GA, United States.
OptiStatim, LLC, Longmeadow, MA, United States.
Resuscitation. 2021 Oct;167:111-117. doi: 10.1016/j.resuscitation.2021.07.034. Epub 2021 Aug 10.
To estimate the annual and lifetime economic productivity loss due to adult out-of-hospital cardiac arrest (OHCA) in the United States (U.S.).
All adult (age ≥ 18 years) non-traumatic EMS-treated OHCA with complete data for age, sex, race, and survival outcomes from the CARES database for 2013-2018 were included. Annual and lifetime labor productivity values, based on age and gender, were obtained from previously published national economic data. Productivity losses for OHCA events were calculated by year in U.S. dollars. Productivity losses for survivors were assigned by cerebral performance category score (CPC): CPC 1 and 2 = 0% productivity loss; CPC 3-5 = 100% productivity loss. Sensitivity analyses were performed assigning CPC 2 varying productivity losses (0-100%) based on CPC score and discharge location. Lifetime productivity values assumed 1% annual growth and 3% discount rate and were adjusted for inflation based on 2016 values. Results were extrapolated to annual U.S. population estimates for the study period.
A total of 338,492 (96.5%) cases met inclusion criteria. The mean annual and lifetime productivity losses per OHCA in 2018 were $48,224 and $638,947 respectively. The total annual economic productivity loss due to OHCA in the U.S. increased from $7.4B in 2013 to $11.3B in 2018. Lifetime economic productivity loss increased from $95.2B in 2013 to $150.2B in 2018. Sensitivity analyses yielded similar findings. Per annual death, OHCA ranked third ($10.2B) in annual economic productivity loss in the U.S. behind cancer ($22.9B) and heart disease ($20.3B) in 2018.
Adult non-traumatic OHCA events are associated with significant annual and lifetime economic productivity losses and should be the focus of public health resources to improve preventative measures and survival outcomes.
估计美国(美国)成人院外心脏骤停(OHCA)造成的年度和终身经济生产力损失。
从 2013 年至 2018 年的 CARES 数据库中纳入所有年龄≥18 岁、非创伤性 EMS 治疗 OHCA 且具有完整年龄、性别、种族和生存结局数据的成年患者。根据年龄和性别,从先前发表的国家经济数据中获得年度和终身劳动生产力价值。按年以美元计算 OHCA 事件的生产力损失。根据脑功能分类评分(CPC)为幸存者分配生产力损失:CPC 1 和 2=0%生产力损失;CPC 3-5=100%生产力损失。进行敏感性分析,根据 CPC 评分和出院地点为 CPC 2 分配 0-100%的可变生产力损失。假设终身生产力价值每年增长 1%,折现率为 3%,并根据 2016 年的价值进行通胀调整。结果外推至研究期间美国的年度人口估计数。
共有 338492 例(96.5%)符合纳入标准。2018 年,每例 OHCA 的平均年度和终身生产力损失分别为 48224 美元和 638947 美元。2013 年至 2018 年,美国 OHCA 导致的年度经济生产力损失从 74 亿美元增加到 113 亿美元。终身经济生产力损失从 2013 年的 952 亿美元增加到 2018 年的 1502 亿美元。敏感性分析得出了类似的结果。按年死亡计算,2018 年 OHCA 在癌症(229 亿美元)和心脏病(203 亿美元)之后,在美国的年度经济生产力损失中排名第三(102 亿美元)。
成人非创伤性 OHCA 事件与重大的年度和终身经济生产力损失相关,应成为公共卫生资源的重点,以改善预防措施和生存结果。