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The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest
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Marti, Joachim, Hulme, Claire, Ferreira, Zenia, Nikolova, Silviya, Lall, Ranjit, Kaye, Charlotte, Smyth, Michael A., Kelly, Charlotte, Quinn, Tom, Gates, Simon, Deakin, Charles D. and Perkins, Gavin D. (2017) The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest. Resuscitation, 117 . pp. 1-7. doi:10.1016/j.resuscitation.2017.04.036
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WRAP-cost-effectiveness-mechanical-compression-device-Perkins-2017.pdf - Accepted Version - Requires a PDF viewer. Download (792Kb) | Preview |
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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2017.04....
Abstract
Aim:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Cardiac arrest -- Treatment -- Technological innovations, Cardiac resuscitation, CPR (First aid) | ||||||||
| Journal or Publication Title: | Resuscitation | ||||||||
| Publisher: | Elsevier Ireland Ltd | ||||||||
| ISSN: | 0300-9572 | ||||||||
| Official Date: | August 2017 | ||||||||
| Dates: |
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| Volume: | 117 | ||||||||
| Page Range: | pp. 1-7 | ||||||||
| DOI: | 10.1016/j.resuscitation.2017.04.036 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Funder: | NIHR Health Technology Assessment Programme (Great Britain) | ||||||||
| Grant number: | Award Number 07/37/69 |
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