Cost-utility of extracorporeal cardiopulmonary resuscitation in patients with cardiac arrest
| Autor: | Jonathan Paul, Atman P. Shah, Janet Friant, Willard W. Sharp, Taishi Hirai, Rhys Chua, David G. Beiser, Murtaza Ismail Bharmal, Jonathan R. Rosenberg, John E.A. Blair, Sandeep Nathan, Joseph M. Venturini, Corey E. Tabit |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost-Benefit Analysis medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Emergency Nursing 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine medicine Hospital discharge Extracorporeal membrane oxygenation Humans Extracorporeal cardiopulmonary resuscitation In patient Registries Hospital Costs Aged Retrospective Studies business.industry Advanced cardiac life support 030208 emergency & critical care medicine Length of Stay Middle Aged Cardiopulmonary Resuscitation Cost utility Emergency medicine Emergency Medicine Female Quality-Adjusted Life Years Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest Health Utilities Index |
| Zdroj: | Resuscitation. 136:126-130 |
| ISSN: | 0300-9572 |
| Popis: | Extracorporeal cardiopulmonary resuscitation (ECPR) is a resource-intensive tool that provides haemodynamic and respiratory support in patients who have suffered cardiac arrest. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution.We performed a retrospective review of patients who received ECPR following cardiac arrest between 2012 and 2018. All medical care-associated charges with ECPR and subsequent hospital admission were recorded. The quality-of-life of survivors was assessed with the Health Utilities Index Mark II. The cost-utility of ECPR was calculated with cost and quality-of-life data.ECPR was used in 32 patients (15/32 in-hospital, 47%) with a median age of 55.0 years (IQR 46.3-63.3 years), 59% male and 66% African American. The median duration of ECPR support was 2.1 days (IQR 0.9-3.8 days). Survival to hospital discharge was 16%. The median score of the Health Utilities Index Mark II at discharge for the survivors was 0.44 (IQR 0.32-0.52). The median operating cost for patients undergoing ECMO was $125,683 per patient (IQR $49,751-$206,341 per patient). The calculated cost-utility for ECPR was $56,156/QALY gained.The calculated cost-utility is within the threshold considered cost-effective in the United States ($150,000/QALY gained). These results are comparable to the cost-effectiveness of heart transplantation for end-stage heart failure. Larger studies are needed to assess the cost-utility of ECPR and to identify whether other factors, such as patient characteristics, affect the cost-utility benefit. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect