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Venoarterial extracorporeal membrane oxygenation for patients in shock or cardiac arrest secondary to cardiotoxicant poisoning: a cost-effectiveness analysis
- Source :
- Journal of critical care. 30(2)
- Publication Year :
- 2014
-
Abstract
- Purpose Venoarterial extracorporeal membrane oxygenation represents an emerging and recommended option to treat life-threatening cardiotoxicant poisoning. The objective of this cost-effectiveness analysis was to estimate the incremental cost-effectiveness ratio of using venoarterial extracorporeal membrane oxygenation for adults in cardiotoxicant-induced shock or cardiac arrest compared with standard care. Materials and methods Adults in shock or in cardiac arrest secondary to cardiotoxicant poisoning were studied with a lifetime horizon and a societal perspective. Venoarterial extracorporeal membrane oxygenation cost effectiveness was calculated using a decision analysis tree, with the effect of the intervention and the probabilities used in the model taken from an observational study representing the highest level of evidence available. The costs (2013 Canadian dollars, where $1.00 Canadian = $0.9562 US dollars) were documented with interviews, reviews of official provincial documents, or published articles. A series of one-way sensitivity analyses and a probabilistic sensitivity analysis using Monte Carlo simulation were used to evaluate uncertainty in the decision model. Results The cost per life year (LY) gained in the extracorporeal membrane oxygenation group was $145 931/18 LY compared with $88 450/10 LY in the non-extracorporeal membrane oxygenation group. The incremental cost-effectiveness ratio ($7185/LY but $34 311/LY using a more pessimistic approach) was mainly influenced by the probability of survival. The probabilistic sensitivity analysis identified variability in both cost and effectiveness. Conclusion Venoarterial extracorporeal membrane oxygenation may be cost effective in treating cardiotoxicant poisonings.
- Subjects :
- Adult
Male
medicine.medical_specialty
Canada
Cost effectiveness
medicine.medical_treatment
Cost-Benefit Analysis
Shock, Cardiogenic
Critical Care and Intensive Care Medicine
Cardiotoxins
Decision Support Techniques
Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation
Medicine
Humans
Intensive care medicine
health care economics and organizations
Aged
business.industry
Extracorporeal circulation
Cost-effectiveness analysis
Oxygenation
Health Care Costs
Middle Aged
Heart Arrest
Treatment Outcome
Shock (circulatory)
Emergency medicine
Observational study
Female
medicine.symptom
business
Monte Carlo Method
Decision analysis
Subjects
Details
- ISSN :
- 15578615
- Volume :
- 30
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of critical care
- Accession number :
- edsair.doi.dedup.....36f3939b628beae7d81438ac6cdd45be