Cost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arrest

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dc.contributor.authorBurišková, Klára
dc.contributor.authorRogalewicz, Vladimír
dc.contributor.authorOšťádal, Petr
dc.contributor.otherEkonomická fakultacs
dc.date.accessioned2019-06-15T15:51:00Z
dc.date.available2019-06-15T15:51:00Z
dc.description.abstractExtracorporeal cardiopulmonary resuscitation (ECPR) has been recently introduced as a therapeutic option for refractory cardiac arrest. Despite growing evidence demonstrating improved survival rate, a number of questions remains unanswered and data on cost-effectiveness are still insufficient. The paper is based on a retrospective observational comparative study of authentic clinical data from patient records. Incremental cost-effectiveness and cost-utility analyses were performed from health care provider's perspective. Sixteen patients undergoing ECPR were included into the analysis and their data were compared with 35 subjects with conventional CPR for refractory cardiac arrest. In the ECPR group eight out of sixteen patients were weaned from ECMO, four of them with good neurological outcomes (CPC 1-2); three patients survived one year with CPC 1-2, one patient survived one year with severe neurological dysfunction (CPC 3), and one patient with persisting coma (CPC 4). In comparison, in the non-ECPR group all patients died within 24 hours. In the ECPR group, the average annual costs per patient reached CZK 885,044 (Levitronix Centrimag), and CZK 788,432 (Cardiohelp) (the 2013 price level). CUA revealed 3,961,970 CZK/QALY with Cardiohelp, and 4,447,457 CZK/QALY with Levitronix. However, if only patients with CPC 1-2 were included into the analysis, the cost-utility ratio decreased below the unofficial Czech cost-effectiveness threshold. Our data indicate that ECPR for refractory cardiac arrest may be cost-effective despite high costs per individual patients, especially if we were able to better select patients for this intervention based on a reliable prediction of the neurological outcome.en
dc.formattext
dc.identifier.doi10.15240/tul/001/2019-2-011
dc.identifier.eissn2336-5604
dc.identifier.issn1212-3609
dc.identifier.urihttps://dspace.tul.cz/handle/15240/152602
dc.language.isoen
dc.publisherTechnická Univerzita v Libercics
dc.publisherTechnical university of Liberec, Czech Republicen
dc.publisher.abbreviationTUL
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dc.rightsCC BY-NC
dc.subjectcost-effectivenessen
dc.subjectcost-utilityen
dc.subjectextracorporeal cardiopulmonary resuscitationen
dc.subjectECPRen
dc.subjectrefractory cardiac arresten
dc.subject.classificationI12
dc.titleCost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arresten
dc.typeArticleen
local.accessopen
local.citation.epage172
local.citation.spage161
local.facultyFaculty of Economics
local.filenameEM_2_2019_11
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local.relation.abbreviationE+Mcs
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local.relation.issue2
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