Kim Stitzel, M.S., R.D., Senior Vice President, Centers for Health Metrics and Evaluation
It’s time for the United States to amp up public health policies and resources to address sudden cardiac arrest, based on results of a new study.
Authored by researchers at five U.S. universities and published in the American Heart Association’s journal Circulation: Cardiovascular Quality and Outcomes, the study provides the first estimate of years of healthy life lost due to out-of-hospital cardiac arrest (OHCA) in the United States.
Researchers determined the loss of healthy years of life by using a metric called a disability-adjusted life year (DALY), which considers years of life lost (YLL) and years lived with disability (YLD). One DALY is equal to one year of healthy life lost.
The ongoing Global Burden of Disease Study has been estimating DALYs for more than 300 diseases and injuries, but not for sudden cardiac arrest.
To fill this gap, the new study estimated the number of DALYs following non-traumatic, EMS-treated OHCA. Researchers then compared those DALYs to other leading causes of death and disability in the United States.
- The rate of DALYs from OHCA is the third highest (1,347 per 100,000 individuals), after ischemic heart disease (2,447) and low back and neck pain (1,565). Stroke, another common time-sensitive condition, is ninth (980).
- NIH research funding for ischemic heart disease was about $2,200 per annual death in 2015, while research for sudden cardiac arrest received $91 per death. Separate reporting of cardiac arrest disease burden may help highlight its public health impact, encourage its study by more investigators, and help aid funding agencies with resource allocation.
- Bystander CPR and automated external defibrillator use are associated with a decrease in DALYs caused by OHCA. This supports funding and implementing policies to help train more people to perform CPR and use AEDs that should be placed in more public areas.
Why DALYs Matter
Along with other measures of disease such as overall incidence, prevalence and number of deaths, DALYs inform policy makers, funders and other decision makers as they allocate resources for research, prevention and treatment of different diseases.
The AHA will soon begin measuring its progress toward promoting longer, healthier lives using the metric of healthy life expectancy (HALE). At the same time, we will continue to rely on metrics like DALY to pinpoint the burden of cardiovascular diseases and its risk factors — informing and guiding our research activities, educational efforts and advocacy priorities.