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


CONCLUSIONS
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.
Graf
Jürgen
J
Department of Anaesthesia and Intensive Care Medicine, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany. jgraf@gmx.de
Mühlhoff
Cecile
C
Doig
Gordon S
GS
Reinartz
Sebastian
S
Bode
Kirsten
K
Dujardin
Robert
R
Koch
Karl-Christian
KC
Roeb
Elke
E
Janssens
Uwe
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006323:Heart Arrest / Q000191:economics* / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000639:trends; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics* / Q000639:trends; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D015996:Survival Rate / Q000639:trends; D017741:Survivors