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      National Institutes of Health–Funded Cardiac Arrest Research: A 10‐Year Trend Analysis

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          Abstract

          Background

          Cardiac arrest ( CA) is a leading cause of death in the United States, claiming over 450 000 lives annually. Improving survival depends on the ability to conduct CA research and on the translation and implementation of research findings into practice. Our objective was to provide a descriptive analysis of annual National Institutes of Health ( NIH) funding for CA research over the past decade.

          Method and Results

          A search within NIH Re PORTER for the years 2007 to 2016 was performed using the terms: “cardiac arrest” or “cardiopulmonary resuscitation” or “heart arrest” or “circulatory arrest” or “pulseless electrical activity” or “ventricular fibrillation” or “resuscitation.” Grants were reviewed and categorized as CA research (yes/no) using predefined criteria. The annual NIH funding for CA research, number of individual grants, and principal investigators were tabulated. The total NIH investment in CA research for 2015 was calculated and compared to those for other leading causes of death within the United States. Interrater reliability among 3 independent reviewers for fiscal year 2015 was assessed using Fleiss κ. The search yielded 2763 NIH‐funded grants, of which 745 (27.0%) were classified as CA research (κ=0.86 [95% CI 0.80‐0.93]). Total inflation‐adjusted NIH funding for CA research was $35.4 million in 2007, peaked at $76.7 million in 2010, and has decreased to $28.5 million in 2016. Per annual death, NIH invests ≈$2200 for stroke, ≈$2100 for heart disease, and ≈$91 for CA.

          Conclusions

          This analysis demonstrates that the annual NIH investment in CA research is low relative to other leading causes of death in the United States and has declined over the past decade.

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          Most cited references5

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          Incidence of treated cardiac arrest in hospitalized patients in the United States.

          The incidence and incidence over time of cardiac arrest in hospitalized patients is unknown. We sought to estimate the event rate and temporal trends of adult inhospital cardiac arrest treated with a resuscitation response. Three approaches were used to estimate the inhospital cardiac arrest event rate. First approach: calculate the inhospital cardiac arrest event rate at hospitals (n = 433) in the Get With The Guidelines-Resuscitation registry, years 2003-2007, and multiply this by U.S. annual bed days. Second approach: use the Get With The Guidelines-Resuscitation inhospital cardiac arrest event rate to develop a regression model (including hospital demographic, geographic, and organizational factors), and use the model coefficients to calculate predicted event rates for acute care hospitals (n = 5445) responding to the American Hospital Association survey. Third approach: classify acute care hospitals into groups based on academic, urban, and bed size characteristics, and determine the average event rate for Get With The Guidelines-Resuscitation hospitals in each group, and use weighted averages to calculate the national inhospital cardiac arrest rate. Annual event rates were calculated to estimate temporal trends. Get With The Guidelines-Resuscitation registry. Adult inhospital cardiac arrest with a resuscitation response. The mean adult treated inhospital cardiac arrest event rate at Get With The Guidelines-Resuscitation hospitals was 0.92/1000 bed days (interquartile range 0.58 to 1.2/1000). In hospitals (n = 150) contributing data for all years of the study period, the event rate increased from 2003 to 2007. With 2.09 million annual U.S. bed days, we estimated 192,000 inhospital cardiac arrests throughout the United States annually. Based on the regression model, extrapolating Get With The Guidelines-Resuscitation hospitals to hospitals participating in the American Hospital Association survey projected 211,000 annual inhospital cardiac arrests. Using weighted averages projected 209,000 annual U.S. inhospital cardiac arrests. There are approximately 200,000 treated cardiac arrests among U.S. hospitalized patients annually, and this rate may be increasing. This is important for understanding the burden of inhospital cardiac arrest and developing strategies to improve care for hospitalized patients.
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            Cardiac arrest: a public health perspective.

            This article reviews out-of-hospital cardiac arrest from a public health perspective. Case definitions are discussed. Incidence, outcome, and fixed and modifiable risk factors for cardiac arrest are described. There is a large variation in survival between communities that is not explained by patient or community factors. Study of variation in outcome in other related conditions suggest that this is due to differences in organizational culture rather than processes of care. A public health approach to improving outcomes is recommended that includes ongoing monitoring and improvement of processes and outcome of care.
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              Cardiac arrest and resuscitation: an opportunity to align research prioritization and public health need.

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                Author and article information

                Contributors
                rcoute@med.umich.edu
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                12 July 2017
                July 2017
                : 6
                : 7 ( doiID: 10.1002/jah3.2017.6.issue-7 )
                : e005239
                Affiliations
                [ 1 ] Department of Emergency Medicine University of Michigan Ann Arbor MI
                [ 2 ] Kansas City University of Medicine and Biosciences Kansas City MO
                [ 3 ] Department of Emergency Medicine Ohio State University Columbus OH
                [ 4 ] Department of Emergency Medicine Baystate Medical Center University of Massachusetts Medical School‐Baystate Springfield MA
                [ 5 ] Michigan Center for Integrative Research in Critical Care University of Michigan Ann Arbor MI
                Author notes
                [*] [* ] Correspondence to: Ryan A. Coute, BS, Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 48104. E‐mail: rcoute@ 123456med.umich.edu
                Article
                JAH32314
                10.1161/JAHA.116.005239
                5586273
                28701308
                aed485a5-2fbd-491e-8823-914a24f771de
                © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 03 December 2016
                : 04 May 2017
                Page count
                Figures: 3, Tables: 1, Pages: 6, Words: 4175
                Funding
                Funded by: the Sarnoff Cardiovascular Research Foundation
                Categories
                Original Research
                Original Research
                Resuscitation Science
                Custom metadata
                2.0
                jah32314
                July 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.4 mode:remove_FC converted:25.07.2017

                Cardiovascular Medicine
                cardiac arrest,national institutes of health,research funding,sudden cardiac death

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