Objective

To estimate the annual and lifetime economic productivity loss due to adult out-of-hospital cardiac arrest (OHCA) in the United States (U.S.).

Methods

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.

Results

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.

Conclusion

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.

中文翻译：

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美国成人院外心脏骤停导致的年度和终生经济生产力损失：针对 CARES 监测小组的一项研究

客观的

估计美国 (US) 成人院外心脏骤停 (OHCA) 造成的年度和终生经济生产力损失。

方法

所有成人（年龄≥ 18 岁）非创伤性 EMS 治疗的 OHCA 都包括来自 CARES 数据库 2013-2018 年的年龄、性别、种族和生存结果的完整数据。基于年龄和性别的年度和终生劳动生产率值是从先前公布的国家经济数据中获得的。OHCA 事件的生产力损失按年以美元计算。幸存者的生产力损失由大脑表现类别评分 (CPC) 分配：CPC 1 和 2 = 0% 生产力损失；CPC 3–5 = 100% 生产力损失。执行敏感性分析，根据 CPC 分数和排放位置分配 CPC 2 不同的生产力损失（0-100%）。终身生产力价值假设年增长率为 1%，贴现率为 3%，并根据 2016 年的价值根据通货膨胀进行了调整。结果被外推到美国年度

结果

共有 338,492 (96.5%) 例符合纳入标准。2018 年每个 OHCA 的平均年度和终生生产力损失分别为 48,224 美元和 638,947 美元。美国 OHCA 造成的年度经济生产力损失总额从 2013 年的 7.4B 美元增加到 2018 年的 11.3B 美元。终生经济生产力损失从 2013 年的 95.2B 美元增加到 2018 年的 150.2B 美元。敏感性分析得出了类似的发现。2018 年，OHCA 在美国每年的经济生产力损失中排名第三（$10.2B），仅次于癌症（$22.9B）和心脏病（$20.3B）。

结论

成人非创伤性 OHCA 事件与重大的年度和终生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。