Introduction: Few population-based studies quantify the societal burden of sudden death. Years of potential life lost (YPLL) is a measure of social and economic loss due to premature death. We aimed to compare YPLL from out-of-hospital sudden deaths (OHSD) to leading causes of death in the state of North Carolina (NC).
Methods: From 2013-2015, all out-of-hospital deaths aged 18-64 reported by EMS in Wake County, NC were screened to adjudicate OHSD. Incidence rates for OHSD in Wake were calculated by age-sex group, and were used to estimate age-standardized OHSD incidence rates in NC. Leading causes of death were identified from the annual NC State Center for Health Statistics report, and total number of deaths for these causes were obtained from statewide death certificates, stratified by age-sex group. For OHSD and other causes, YPLL was calculated by multiplying the number of deaths in each age-sex group by the remaining life expectancy of NC residents in that group.
Results: We identified 399 cases of OHSD in Wake County, yielding an annual incidence rate of 30.7 per 100,000. Age-standardized incidence rates in NC were 33.8 (95% CI 32.3-35.3), 48.2 (95% CI 45.6-50.7) and 20.6 (95% CI 19.0-22.2) per 100,000 among all, men and women, respectively. Total YPLL from OHSD (63,104 95% CI 63,070-63,279) accounted for 10% of YPLL from all deaths aged 18-64 in NC. Total YPLL from OHSD exceeded that of individual cancers, cerebrovascular disease, diabetes and chronic respiratory disease. Total YPLL from OHSD among men was about twice that of women. YPLL from OHSD was greatest in the 55-59 age group in both sexes. For men and women, YPLL from OHSD exceeded unintentional injuries after age 55, but remained lower than heart disease. (Figure)
Conclusions: Sudden death carries a substantial societal burden relative to leading causes of death. This finding justifies a collaborative effort to prioritize preventive health policies and interventions that reduce public health burden of sudden death.