Guillaume Geri1, Carol Fahrenbruch2, Hendrika Meischke3, Ian Painter3, Lindsay White4, Thomas D Rea2, Marcia R Weaver3. 1. Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. Electronic address: gerig@smh.ca. 2. Division of EMS, Public Health, Seattle & King County, Seattle, WA, USA. 3. Department of Health Services, University of Washington, Seattle, WA, USA. 4. Division of EMS, Public Health, Seattle & King County, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA. Utstein-style information was obtained from the EMS registry, including 5-year survival. Costs from the OHCA hospitalization were obtained from the Washington State Comprehensive Hospital Abstract Reporting System. Cost effectiveness was based on hospital costs divided by quality-adjusted life years (QALYs) for a 5-year follow-up window. RESULTS: Of the 4448 eligible patients, 18.5% (n=824) were discharged alive from hospital and 12.1% (n=539) were alive at 5 years. Five-year survival was higher in patients who received bystander CPR (14.3% vs. 8.7%, p<0.001) translating to an average 0.09 QALYs associated with bystander CPR. The average (SD) total cost of the initial acute care hospitalization was USD 19,961 (40,498) for all admitted patients and USD 75,175 (52,276) for patients alive at year 5. The incremental cost-effectiveness ratio associated with bystander CPR was USD 48,044 per QALY. CONCLUSION: Based on this population-based investigation, bystander CPR was positively associated with long-term survival and appears cost-effective.
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA. Utstein-style information was obtained from the EMS registry, including 5-year survival. Costs from the OHCA hospitalization were obtained from the Washington State Comprehensive Hospital Abstract Reporting System. Cost effectiveness was based on hospital costs divided by quality-adjusted life years (QALYs) for a 5-year follow-up window. RESULTS: Of the 4448 eligible patients, 18.5% (n=824) were discharged alive from hospital and 12.1% (n=539) were alive at 5 years. Five-year survival was higher in patients who received bystander CPR (14.3% vs. 8.7%, p<0.001) translating to an average 0.09 QALYs associated with bystander CPR. The average (SD) total cost of the initial acute care hospitalization was USD 19,961 (40,498) for all admitted patients and USD 75,175 (52,276) for patients alive at year 5. The incremental cost-effectiveness ratio associated with bystander CPR was USD 48,044 per QALY. CONCLUSION: Based on this population-based investigation, bystander CPR was positively associated with long-term survival and appears cost-effective.
Authors: Simon A Amacher; Chantal Bohren; René Blatter; Christoph Becker; Katharina Beck; Jonas Mueller; Nina Loretz; Sebastian Gross; Kai Tisljar; Raoul Sutter; Christian Appenzeller-Herzog; Stephan Marsch; Sabina Hunziker Journal: JAMA Cardiol Date: 2022-06-01 Impact factor: 30.154
Authors: Emílio Carlos Alves Dos Santos; Cor Jesus Fernandes Fontes; Eloana Ferreira D'Artibale; Jocilene de Carvalho Miravete; Gimerson Erick Ferreira; Mara Regina Rosa Ribeiro Journal: Rev Lat Am Enfermagem Date: 2021-07-02