The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest.
Détails
ID Serval
serval:BIB_ECADF1F9A139
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest.
Périodique
Resuscitation
ISSN
1873-1570 (Electronic)
ISSN-L
0300-9572
Statut éditorial
Publié
Date de publication
08/2017
Peer-reviewed
Oui
Volume
117
Pages
1-7
Langue
anglais
Résumé
To assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest.
We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model.
4471 patients were enrolled in the trial (1652 assigned to the LUCAS-2 group, 2819 assigned to the control group). At 12 months, 89 (5%) patients survived in the LUCAS-2 group and 175 (6%) survived in the manual CPR group. In the vast majority of analyses conducted, both within-trial and by extrapolation of the results over a lifetime horizon, manual CPR dominates LUCAS-2. In other words, patients in the LUCAS-2 group had poorer health outcomes (i.e. lower QALYs) and incurred higher health and social care costs.
Our study demonstrates that the use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest.
We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model.
4471 patients were enrolled in the trial (1652 assigned to the LUCAS-2 group, 2819 assigned to the control group). At 12 months, 89 (5%) patients survived in the LUCAS-2 group and 175 (6%) survived in the manual CPR group. In the vast majority of analyses conducted, both within-trial and by extrapolation of the results over a lifetime horizon, manual CPR dominates LUCAS-2. In other words, patients in the LUCAS-2 group had poorer health outcomes (i.e. lower QALYs) and incurred higher health and social care costs.
Our study demonstrates that the use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest.
Mots-clé
Cardiopulmonary Resuscitation/economics, Cardiopulmonary Resuscitation/methods, Cardiopulmonary Resuscitation/mortality, Case-Control Studies, Cost-Benefit Analysis, Emergency Medical Services/economics, Female, Heart Massage/economics, Heart Massage/instrumentation, Hospitalization/economics, Humans, Male, Middle Aged, Out-of-Hospital Cardiac Arrest/mortality, Out-of-Hospital Cardiac Arrest/therapy, Quality of Life, Quality-Adjusted Life Years, Surveys and Questionnaires, Treatment Outcome, Cardiac arrest, Cost-effectiveness, Health economics, Mechanical compression
Pubmed
Web of science
Création de la notice
27/04/2018 14:29
Dernière modification de la notice
20/08/2019 17:14