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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 ISSN 0300-9572.

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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2017.04....

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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
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
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:
DateEvent
August 2017Published
2 May 2017Available
30 April 2017Accepted
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
Date of first compliant deposit: 28 June 2017
Date of first compliant Open Access: 2 May 2018
Funder: NIHR Health Technology Assessment Programme (Great Britain)
Grant number: Award Number 07/37/69

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