Health care costs, long-term survival, and quality of life following intensive care unit admission after cardiac arrest

Crit Care. 2008;12(4):R92. doi: 10.1186/cc6963. Epub 2008 Jul 18.

Abstract

Introduction: The purpose of this study was to investigate the costs and health status outcomes of intensive care unit (ICU) admission in patients who present after sudden cardiac arrest with in-hospital or out-of-hospital cardiopulmonary resuscitation.

Methods: Five-year survival, health-related quality of life (Medical Outcome Survey Short Form-36 questionnaire, SF-36), ICU costs, hospital costs and post-hospital health care costs per survivor, costs per life year gained, and costs per quality-adjusted life year gained of patients admitted to a single ICU were assessed.

Results: One hundred ten of 354 patients (31%) were alive 5 years after hospital discharge. The mean health status index of 5-year survivors was 0.77 (95% confidence interval 0.70 to 0.85). Women rated their health-related quality of life significantly better than men did (0.87 versus 0.74; P < 0.05). Costs per hospital discharge survivor were 49,952 euro. Including the costs of post-hospital discharge health care incurred during their remaining life span, the total costs per life year gained were 10,107 euro. Considering 5-year survivors only, the costs per life year gained were calculated as 9,816 euro or 14,487 euro per quality-adjusted life year gained. Including seven patients with severe neurological sequelae, costs per life year gained in 5-year survivors increased by 18% to 11,566 euro.

Conclusion: Patients who leave the hospital following cardiac arrest without severe neurological disabilities may expect a reasonable quality of life compared with age- and gender-matched controls. Quality-adjusted costs for this patient group appear to be within ranges considered reasonable for other groups of patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Care Costs* / trends
  • Heart Arrest / economics*
  • Heart Arrest / therapy*
  • Humans
  • Intensive Care Units / economics*
  • Intensive Care Units / trends
  • Male
  • Middle Aged
  • Patient Admission / economics*
  • Patient Admission / trends
  • Prospective Studies
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Survival Rate / trends
  • Survivors