Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Cooling therapy for cardiac arrest survivors is as cost-effective as accepted treatments for other conditions

06.08.2009
Study Highlights:

The cost effectiveness of post-resuscitation therapeutic hypothermia is comparable to widely accepted treatments for other medical conditions.

Lowering the body temperature of cardiac arrest patients can reduce death and disability if they survive out-of-hospital cardiac arrest due to ventricular fibrillation (VF), but hospitals have not widely adopted the treatment.

Researchers say from a societal perspective, the benefits of post-resuscitation hypothermia justify its costs.

Cooling unconscious cardiac arrest survivors can increase survival and has a cost effectiveness comparable to other widely accepted treatments in modern health care, researchers report in Circulation: Cardiovascular Quality and Outcomes.

Out-of-hospital cardiac arrest – in which the heart stops effectively pumping blood through the body – annually occurs in about 300,000 adults in the United States.

“Therapeutic hypothermia is the only post-resuscitation therapy shown to improve both survival and reduce disability after cardiac arrest,” said lead author Raina M. Merchant, M.D., M.S., a Robert Wood Johnson Foundation Clinical Scholar and emergency medicine physician at the University of Pennsylvania School of Medicine in Philadelphia.

“Since 2003, the American Heart Association has recommended that comatose (unconscious) patients with spontaneous circulation after out-of-hospital ventricular fibrillation (VF) cardiac arrest should receive therapeutic hypothermia,” Merchant said. “Despite repeating this recommendation in the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, along with other studies that show its benefits, therapeutic hypothermia hasn’t been adopted as quickly as one would hope. We thought it would be a good idea to determine whether cost should be a barrier to its use.”

With therapeutic hypothermia, a patient’s body temperature is cooled and the patient is monitored so that their internal body temperature remains between 32 and 34 degrees centigrade (89.6 to 93.2 degrees Fahrenheit) for at least 12 to 24 hours. Cooling blankets, one of several technologies used to accomplish therapeutic cooling, were the focus of the current analysis.

Researchers used a complex mathematical design to measure quality-adjusted survival after cardiac arrest, cost of hypothermia treatment, cost of post-hospital discharge care and incremental cost-effectiveness ratios. Factors affecting costs included additional nursing care required during cooling treatment, extra time spent in the intensive care unit and post-discharge care required.

Merchant said, “Quality adjusted life year calculations were based on previous studies of patients with cardiac arrest.”

Quality adjusted life years (QALY) are a measurement of health outcomes that are calculated by combining quality of life and life expectancy.

The incremental cost-effectiveness ratio (ICER) for therapeutic hypothermia compared with conventional care (post-resuscitation care without hypothermia) was $47,168/ (QALY), Merchant said.

“We found that even at extreme estimates for costs, the cost-effectiveness of hypothermia remained less than $100,000/QALY in more than 91 percent of our simulations,” she said.

Researchers used data from two landmark papers published in 2002 by the Hypothermia After Cardiac Arrest (HACA) study group, which reported that therapeutic hypothermia improves survival and neurologic outcomes in comatose resuscitated cardiac arrest patients. In addition, researchers used information from cooling device companies and consultation with resuscitation experts.

In comparison, other studies estimated the ICER of kidney dialysis at $55,000/QALY. Public access defibrillation — the placement of automated external defibrillators (AEDs) in public places — has an ICER of $44,000/QALY. Placing AEDs on all U.S. commercial aircraft has an estimated cost of $94,700/QALY, researchers added.

“We showed that therapeutic hypothermia is a good value for the cost,” Merchant said. “In fact, even if a hospital had only one patient eligible for hypothermia therapy annually, and considerable post-resuscitation care costs resulted for survivors, the cost-effectiveness is consistent with many widely accepted healthcare interventions.”

One of the limitations of the current study is the lack of long-term outcomes data, which Merchant hopes will be overcome with future research.

Co-authors are Lance B. Becker, M.D.; Benjamin S. Abella, M.D., M.Phil.; David A. Asch, M.D., M.B.A. and Peter W. Groeneveld, M.D., M.S. Individual author disclosures are on the manuscript.

The study was funded by the Robert Wood Johnson Foundation’s Clinical Scholars program at the University of Pennsylvania (Dr. Merchant), and by a Career Development Transition Award from the Veterans Affairs Health Services Research and Development Service (Dr. Groeneveld).

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.

Tagni McRae | EurekAlert!
Further information:
http://www.heart.org

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Pulverizing electronic waste is green, clean -- and cold

22.03.2017 | Materials Sciences

Astronomers hazard a ride in a 'drifting carousel' to understand pulsating stars

22.03.2017 | Physics and Astronomy

New gel-like coating beefs up the performance of lithium-sulfur batteries

22.03.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>