Ryan Coute, DO

University of Alabama at Birmingham

"Disability-adjusted Life Years Following Out-of-hospital Cardiac Arrest"
SAEMF/RAMS Resident Research Grant




Cardiac arrest describes a state in which the heart suddenly stops beating and blood flow to the brain and other vital organs is interrupted. Cardiac arrest (CA) is one of the most critical conditions in medicine, resulting in over 450,000 deaths each year in the United States (U.S.). The public health impact of CA is often presented as overall incidence, number of deaths, or short-term neurologic outcomes that are derived from large data registries for both in-hospital and out-of-hospital CA (OHCA). The recent Institute of Medicine report entitled, Strategies to Improve Cardiac Arrest Survival: A Time to Act, identifies the need for additional disease burden measures for CA beyond those traditionally reported. The proposed research will address this need by providing CA burden of disease benchmarks using standardized disability-adjusted life year metrics. The disability-adjusted life year (DALY), a measure of overall disease burden that takes into consideration both potential years of life lost due to premature death and equivalent years of healthy life lost due to disability, combines morbidity and mortality into a single public health metric. DALYs are frequently used to estimate the public health impact of a disease and to compare the relative burden of one disease to another. DALY estimates for OHCA in the U.S. are currently unknown.

This project will estimate DALY values for OHCA using prospectively collected data from the national Cardiac Arrest Registry to Enhance Survival (CARES) database. Specific Aims include: (1) establishing DALY values for OHCA in the U.S., (2) testing the reproducibility of DALY values for OHCA in the U.S. from 2013 to 2017, and (3) comparing the relative burden of disease rank for OHCA across this 5-year period. Our central hypothesis is that DALY values for OHCA can be determined using CARES data, and that OHCADALY values will remain stable over time and will consistently place OHCA among the top five annual causes of DALY in the U.S. The scientific premise for this study is that DALY values for OHCA are currently unknown and the CARES dataset is ideal for generating these estimates. Our overall goal is to provide a new metric for OHCA that will allow for disease burden comparison using established population health standards. Furthermore, the results will help funding agencies and policy makers decide how to best utilize limited resources to maximize potential benefit.

The disability-adjusted life year (DALY) is a standardized public health metric used to estimate and compare the burden of one disease to another. DALY estimates for out-of-hospital cardiac arrest (OHCA) are currently unknown. We will estimate DALYs for OHCA and test OHCADALY stability as a burden of disease measure. Results will inform policy makers and funding agencies about the public health burden associated with OHCA, and allow for disease burden comparisons using population health standards.

Research Results

Dr. Rotoli is still completing the project.