Comparative cost-effectiveness of termination of resuscitation rules for patients transported in cardiac arrest.
Resuscitation
; 201: 110274, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38879073
ABSTRACT
AIM:
To compare the cost-effectiveness of termination-of-resuscitation (TOR) rules for patients transported in cardiac arrest.METHODS:
The economic analyses evaluated cost-effectiveness of alternative TOR rules for OHCA from a National Health Service (NHS) and personal social services (PSS) perspective over a lifetime horizon. A systematic review was used to identify the different TOR rules included in the analyses. Data from the OHCAO outcomes registry, trial data and published literature were used to compare outcomes for the different rules identified. The economic analyses estimated discounted NHS and PSS costs and quality-adjusted life-years (QALYs) for each TOR rule, based on which incremental cost-effectiveness ratios (ICERs) were calculated.RESULTS:
The systematic review identified 33 TOR rules and the economic analyses assessed the performance of 29 of these TOR rules plus current practice. The most cost-effective strategies were the European Resuscitation Council (ERC) termination of resuscitation rule (ICER of £8,111), the Korean Cardiac Arrest Research Consortium 2 (KOC 2) termination of resuscitation rule (ICER of £17,548), and the universal Basic Life Support (BLS) termination of resuscitation rule (ICER of £19,498,216). The KOC 2 TOR rule was cost-effective at the established cost-effectiveness threshold of £20,000-£30,000 per QALY.CONCLUSION:
The KOC 2 rule is the most cost-effective at established cost-effectiveness thresholds used to inform health care decision-making in the UK. Further research on economic implications of TOR rules is warranted to support constructive discussion on implementing TOR rules.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cost-Benefit Analysis
/
Out-of-Hospital Cardiac Arrest
Limits:
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
Resuscitation
Year:
2024
Document type:
Article
Country of publication:
Ireland