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Cost-effectiveness of the i-gel supraglottic airway device compared to tracheal intubation during out-of-hospital cardiac arrest: Findings from the AIRWAYS-2 randomised controlled trial.
- Source :
-
Resuscitation . Oct2021, Vol. 167, p1-9. 9p. - Publication Year :
- 2021
-
Abstract
- <bold>Aim: </bold>Optimal airway management during out-of-hospital cardiac arrest (OHCA) is uncertain. Complications from tracheal intubation (TI) may be avoided with supraglottic airway (SGA) devices. The AIRWAYS-2 cluster randomised controlled trial (ISRCTN08256118) compared the i-gel SGA with TI as the initial advanced airway management (AAM) strategy by paramedics treating adults with non-traumatic OHCA. This paper reports the trial cost-effectiveness analysis.<bold>Methods: </bold>A within-trial cost-effectiveness analysis of the i-gel compared with TI was conducted, with a six-month time horizon, from the perspective of the UK National Health Service (NHS) and personal social services. The primary outcome measure was quality-adjusted life years (QALYs), estimated using the EQ-5D-5L questionnaire. Multilevel linear regression modelling was used to account for clustering by paramedic when combining costs and outcomes.<bold>Results: </bold>9296 eligible patients were attended by 1382 trial paramedics and enrolled in the AIRWAYS-2 trial (4410 TI, 4886 i-gel). Mean QALYs to six months were 0.03 in both groups (i-gel minus TI difference -0.0015, 95% CI -0.0059 to 0.0028). Total costs per participant up to six months post-OHCA were £3570 and £3413 in the i-gel and TI groups respectively (mean difference £157, 95% CI -£270 to £583). Based on mean difference point estimates, TI was more effective and less costly than i-gel; however differences were small and there was great uncertainty around these results.<bold>Conclusion: </bold>The small differences between groups in QALYs and costs shows no difference in the cost-effectiveness of the i-gel and TI when used as the initial AAM strategy in adults with non-traumatic OHCA. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CARDIAC arrest
*AIRWAY (Anatomy)
*TRACHEA intubation
*COST effectiveness
*MULTILEVEL models
*QUALITY-adjusted life years
*BRONCHOSCOPES
*COST estimates
*DEFIBRILLATORS
*CARDIOPULMONARY resuscitation
*RESEARCH
*RESEARCH methodology
*MEDICAL cooperation
*EVALUATION research
*NATIONAL health services
*COMPARATIVE studies
*RANDOMIZED controlled trials
*EMERGENCY medical services
Subjects
Details
- Language :
- English
- ISSN :
- 03009572
- Volume :
- 167
- Database :
- Academic Search Index
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 152979103
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2021.06.002