The cost-effectiveness of a mechanical compression device in out-of-hospital cardiac arrest

Research output: Contribution to journalArticlepeer-review

Authors

  • Joachim Marti
  • Claire Hulme
  • Zenia Ferreira
  • Silviya Nikolova
  • Ranjit Lall
  • Charlotte Kaye
  • Michael Smyth
  • Charlotte Kelly
  • Tom Quinn
  • Charles D. Deakin
  • Gavin D. Perkins

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.

Details

Original languageEnglish
Pages (from-to)1-7
JournalResuscitation
Volume117
Early online date2 May 2017
Publication statusPublished - 1 Aug 2017