Titre
The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Marti, J.
Auteure/Auteur
Hulme, C.
Auteure/Auteur
Ferreira, Z.
Auteure/Auteur
Nikolova, S.
Auteure/Auteur
Lall, R.
Auteure/Auteur
Kaye, C.
Auteure/Auteur
Smyth, M.
Auteure/Auteur
Kelly, C.
Auteure/Auteur
Quinn, T.
Auteure/Auteur
Gates, S.
Auteure/Auteur
Deakin, C.D.
Auteure/Auteur
Perkins, G.D.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1873-1570
Statut éditorial
Publié
Date de publication
2017-08
Volume
117
Première page
1
Dernière page/numéro d’article
7
Peer-reviewed
Oui
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.
Sujets
PID Serval
serval:BIB_ECADF1F9A139
PMID
Date de création
2018-04-27T12:29:17.023Z
Date de création dans IRIS
2025-05-21T05:17:17Z