Assessing the cost-effectiveness of capnography for end-tidal CO 2 monitoring during in-hospital cardiac arrest: A middle-income country perspective analysis.

Autor: da Rosa Decker SR; Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Serviço de Medicina Interna, Hospital Moinhos de Vento, Porto Alegre, Brazil., Marzzani LE; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., de Ferreira PR; Instituto de Cardiologia - Fundação Universitária de Cardiologia, Porto Alegre, Brazil., Rosa PRM; Serviço de Medicina Interna, Hospital Moinhos de Vento, Porto Alegre, Brazil.; Departamento de Medicina Interna, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil., Brauner JS; Departamento de Medicina Interna, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil., Rosa RG; Serviço de Medicina Interna, Hospital Moinhos de Vento, Porto Alegre, Brazil., Bertoldi EG; Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brazil.
Jazyk: angličtina
Zdroj: American heart journal plus : cardiology research and practice [Am Heart J Plus] 2024 Feb 29; Vol. 40, pp. 100373. Date of Electronic Publication: 2024 Feb 29 (Print Publication: 2024).
DOI: 10.1016/j.ahjo.2024.100373
Abstrakt: Study Objective: To evaluate the cost-effectiveness of EtCO 2 monitoring during in-hospital cardiorespiratory arrest (CA) care outside the intensive care unit (ICU) and emergency room department.
Design: We performed a cost-effectiveness analysis based on a simple decision model cost analysis and reported the study using the CHEERS checklist. Model inputs were derived from a retrospective Brazilian cohort study, complemented by information obtained through a literature review. Cost inputs were gathered from both literature sources and contacts with hospital suppliers.
Setting: The analysis was carried out from the perspective of a tertiary referral hospital in a middle-income country.
Participants: The study population comprised individuals experiencing in-hospital CA who received cardiopulmonary resuscitation (CPR) by rapid response team (RRT) in a hospital ward, not in the ICU or emergency room department.
Interventions: Two strategies were assumed for comparison: one with an RRT delivering care without capnography during CPR and the other guiding CPR according to the EtCO 2 waveform.
Main Outcome Measures: Incremental cost-effectiveness rate (ICER) to return of spontaneous circulation (ROSC), hospital discharge, and hospital discharge with good neurological outcomes.
Results: The ICER for EtCO 2 monitoring during CPR, resulting in an absolute increase of one more case with ROSC, hospital discharge, and hospital discharge with good neurological outcome, was calculated at Int$ 515.78 (361.57-1201.12), Int$ 165.74 (119.29-248.4), and Int$ 240.55, respectively.
Conclusion: In managing in-hospital CA in the hospital ward, incorporating EtCO2 monitoring is likely a cost-effective measure within the context of a middle-income country hospital with an RRT.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sergio Renato da Rosa Decker reports financial support was provided by 10.13039/501100002322Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). The authors of this article declare that they have no other conflicts of interest to disclose.
(© 2024 The Authors. Published by Elsevier Inc.)
Databáze: MEDLINE
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