title: Health care costs, long-term survival, and quality of life following intensive care unit admission after cardiac arrest.
abstract: 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.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany. jgraf@gmx.de
authors.forename: Jürgen
authors.initials: J
authors.lastname: Graf
authors.forename: Cecile
authors.initials: C
authors.lastname: Mühlhoff
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Doig
authors.forename: Sebastian
authors.initials: S
authors.lastname: Reinartz
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bode
authors.forename: Robert
authors.initials: R
authors.lastname: Dujardin
authors.forename: Karl-Christian
authors.initials: KC
authors.lastname: Koch
authors.forename: Elke
authors.initials: E
authors.lastname: Roeb
authors.forename: Uwe
authors.initials: U
authors.lastname: Janssens
mesh_terms: 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