Long term survival and costs per life year gained after out-of-hospital cardiac arrest

Næss, Anne-Cathrine; Steen, Petter Andreas

doi:10.1016/s0300-9572(03)00262-4

Cited by 40 publications

(12 citation statements)

References 45 publications

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“…24 In the absence of long-term follow-up data for our 2011–2012 patient population we extrapolated QALY data using survival and utility from previous follow-up studies. Historically studies have been consistent in their reported long-term mean survival post-OOHCA (6.13 years (Norwegian 1971–1992 data) 14 and 6.2 years (Scottish 1991–1998 data) 15 ). Studies have also reported consistent utility following survival after OOHCA, 0.72 in a 2004 American study, 25 0.7 in a Dutch study 26 and 0.77 in a recent German study.…”

Section: Methodsmentioning

confidence: 72%

“…Literature review reveals a scarcity of published data regarding economic costs of OOHCA, particularly within the UK. 14–18 The primary purpose of this study was to provide an up-to-date UK estimate of the in-hospital cost per high-quality OOHCA survivor, based on CPC scoring, within a tertiary referral centre following the introduction of PPCI and TTM in accordance with guidelines. 10 Secondarily, using follow-up outcome data from similar studies, an exploratory estimation was made to determine likely cost-effectiveness based on cost per QALY gained.…”

Section: Introductionmentioning

confidence: 99%

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Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

Petrie¹,

Easton

Naik

et al. 2015

BMJ Open

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ObjectivesThere is a scarcity of literature reporting hospital costs for treating out of hospital cardiac arrest (OOHCA) survivors, especially within the UK. This is essential for assessment of cost-effectiveness of interventions necessary to allow just allocation of resources within the National Health Service. We set out primarily to calculate costs stratified against hospital survival and neurological outcomes. Secondarily, we estimated cost effectiveness based on estimates of survival and utility from previous studies to calculate costs per quality adjusted life year (QALY).SettingWe performed a single centre (London) retrospective review of in-hospital costs of patients admitted to the intensive care unit (ICU) following return of spontaneous circulation (ROSC) after OOHCA over 18 months from January 2011 (following widespread introduction of targeted temperature management and primary percutaneous intervention).ParticipantsOf 69 successive patients admitted over an 18-month period, survival and cerebral performance category (CPC) outcomes were obtained from review of databases and clinical notes. The Trust finance department supplied ICU and hospital costs using the Payment by Results UK system.ResultsOf those patients with ROSC admitted to ICU, survival to hospital discharge (any CPC) was 33/69 (48%) with 26/33 survivors in CPC 1–2 at hospital discharge. Cost per survivor to hospital discharge (including total cost of survivors and non-survivors) was £50 000, cost per CPC 1–2 survivor was £65 000. Cost and length of stay of CPC 1–2 patients was considerably lower than CPC 3–4 patients. The majority of the costs (69%) related to intensive care. Estimated cost per CPC 1–2 survivor per QALY was £16 000.ConclusionsThe costs of in-hospital patient care for ICU admissions following ROSC after OOHCA are considerable but within a reasonable threshold when assessed from a QALY perspective.

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Section: Methodsmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

Petrie¹,

Easton

Naik

et al. 2015

BMJ Open

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“…Previous studies have reported one-year survival rates for hospitaltreated OHCA between 27% and 55%, and for IHCA between 6% and 30% [17][18][19][20][21][22][23]. Over 80% of hospital survivors had favourable neurological outcome [24][25][26][27][28][29][30].…”

Section: Survival and Neurological Outcomementioning

confidence: 94%

“…One of the first studies on costs associated with the treatment of OHCA reported total costs, including pre-hospital and in-hospital costs, for a six-month survivor of €36,000 expressed in 2013 euros [17]. Several more recent studies reported hospital costs per patient between €50,000 and €60,000 in 2013 euros for OHCA and IHCA hospital survivors, with costs per hospital survivor with favourable neurological outcome between €17,000 and €80,000 in 2013 euros [2,19,31,32]. A study by van Alem et al reported healthcare-associated costs during the first half-year after OHCA, including prehospital, in-hospital and posthospital expenses, of €36,600 in 2013 euros [33].…”

Section: Healthcare-associated Costsmentioning

confidence: 99%

Outcomes and healthcare-associated costs one year after intensive care-treated cardiac arrest

et al. 2018

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“…In a report describing the costs of out-of-hospital CAs of cardiac origin [14], the cost per patient discharged alive was €40 642, with a cost of €6632 per life year gained. Moreover, 4.4% of the costs were spent on patients not surviving to hospital, 35.6% on patients dying in the hospital while 60% of the total costs were spent on patients discharged from hospital alive [14]. …”

Section: Discussionmentioning

confidence: 99%

No fate but what we make: a case of full recovery after out-of-hospital cardiac arrest

Miranda

Sousa

Ferreira

et al. 2009

Scand J Trauma Resusc Emerg Med

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An 80 years old man suffered a cardiac arrest shortly after arrival to his local health department. Basic Life Support was started promptly and nine minutes later, on evaluation by an Advanced Life Support team, the victim was defibrillated with a 200J shock. When orotracheal intubation was attempted, masseter muscle contraction was noticed: on revaluation, the victim had pulse and spontaneous breathing.Thirty minutes later, the patient had been transferred to an emergency department. As he complained of chest pain, the ECG showed a ST segment depression in leads V4 to V6 and laboratorial tests showed cardiac troponine I slightly elevated. A coronary angiography was performed urgently: significant left main plus three vessel coronary artery disease was disclosed.Eighteen hours after the cardiac arrest, a quadruple coronary artery bypass grafting operation was undertaken. During surgery, a fresh thrombus was removed from the middle left anterior descendent artery. Post-operative course was uneventful and the patient was discharged seven days after the procedure. Twenty four months later, he remains asymptomatic.In this case, the immediate call for the Advanced Life Support team, prompt basic life support and the successful defibrillation, altogether, contributed for the full recovery. Furthermore, the swiftness in the detection and treatment of the acute reversible cause (myocardial ischemia in this case) was crucial for long-term prognosis.

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Long term survival and costs per life year gained after out-of-hospital cardiac arrest

Cited by 40 publications

References 45 publications

Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

Outcomes and healthcare-associated costs one year after intensive care-treated cardiac arrest

No fate but what we make: a case of full recovery after out-of-hospital cardiac arrest

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