Health-related quality of life, one-year costs and economic evaluation in extracorporeal membrane oxygenation in critically ill adults.

Autor: Oude Lansink-Hartgring A; Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: a.oudelansink@umcg.nl., Miranda DDR; Adult Intensive Care Unit, Erasmus Medical Center, Rotterdam, the Netherlands., Mandigers L; Adult Intensive Care Unit, Erasmus Medical Center, Rotterdam, the Netherlands., Delnoij T; Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands., Lorusso R; Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands., Maas JJ; Adult Intensive Care Unit, Leiden University Medical Center, Leiden, the Netherlands., Elzo Kraemer CV; Adult Intensive Care Unit, Leiden University Medical Center, Leiden, the Netherlands., Vlaar APJ; Department of Intensive Unit, Amsterdam University Medical Centers, Academic Medical Centers, Amsterdam, the Netherlands., Raasveld SJ; Department of Intensive Unit, Amsterdam University Medical Centers, Academic Medical Centers, Amsterdam, the Netherlands., Donker DW; Department of Critical Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Cardiovascular and Respiratory Physiology Group, TechMed Centre, University of Twente, Enschede, the Netherlands., Scholten E; Department of Intensive Care, St. Antonius Hospital, Nieuwegein, the Netherlands., Balzereit A; Department of Critical Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., van den Brule J; Department of Intensive Care, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands., Kuijpers M; Department of Intensive Care, Isala Klinieken, Zwolle, the Netherlands., Vermeulen KM; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van den Bergh WM; Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2023 Feb; Vol. 73, pp. 154215. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1016/j.jcrc.2022.154215
Abstrakt: Purpose: This study reports on survival and health related quality of life (HRQOL) after extracorporeal membrane oxygenation (ECMO) treatment and the associated costs in the first year.
Materials and Methods: Prospective observational cohort study patients receiving ECMO in the intensive care unit during August 2017 and July 2019. We analyzed all healthcare costs in the first year after index admission. Follow-up included a HRQOL analysis using the EQ-5D-5L at 6 and 12 months.
Results: The study enrolled 428 patients with an ECMO run during their critical care admission. The one-year mortality was 50%. Follow up was available for 124 patients at 12 months. Survivors reported a favorable mean HRQOL (utility) of 0.71 (scale 0-1) at 12 months of 0.77. The overall health status (VAS, scale 0-100) was reported as 73.6 at 12 months. Mean total costs during the first year were $204,513 ± 211,590 with hospital costs as the major factor contributing to the total costs. Follow up costs were $53,752 ± 65,051 and costs of absenteeism were $7317 ± 17,036.
Conclusions: At one year after hospital admission requiring ECMO the health-related quality of life is favorable with substantial costs but considering the survival might be acceptable. However, our results are limited by loss of follow up. So it may be possible that only the best-recovered patients returned their questionnaires. This potential bias might lead to higher costs and worse HRQOL in a real-life scenario.
Competing Interests: Declaration of Competing Interest Dirk W. Donker received speaker fee from Getinge-Maquet and Xenios NovaLung Fresenius. Dirk W. Donker has research cooperation's with Getinge-Maquet and Xenios NovaLung Fresenius. Roberto Lorusso is consultant for Medtronic, LivaNova, and Getinge. He is part of the Medical Advisory Board of Eurosets and Xenios. All honoraria are paid to the university for research funding. Dinis dos Reis Miranda received speaking fees from Xenios. The remaining authors have disclosed that they do not have any conflicts of interest.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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