Health-related quality of life, one-year costs and economic evaluation in extracorporeal membrane oxygenation in critically ill adults

• Published in: Journal of critical care 2023-02, Vol.73, p.154215-154215, Article 154215
• Main Authors: Oude Lansink-Hartgring, Annemieke, Miranda, Dinis Dos Reis, Mandigers, Loes, Delnoij, Thijs, Lorusso, Roberto, Maas, Jacinta J., Elzo Kraemer, Carlos V., Vlaar, Alexander P.J., Raasveld, S. Jorinde, Donker, Dirk W., Scholten, Erik, Balzereit, Anja, van den Brule, Judith, Kuijpers, Marijn, Vermeulen, Karin M., van den Bergh, Walter M.
• Format: Article
• Language: English
• Subjects: Adult; Cardiopulmonary resuscitation; Cohort analysis; Cost analysis; Cost-Benefit Analysis; CPR; Critical care; Critical Illness - therapy; Discount rates; Extracorporeal life support; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation - methods; Hospital costs; Humans; Life expectancy; Mortality; Outcome; Patients; Prospective Studies; Quality of Life; Questionnaires; Respiratory distress syndrome
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2022.154215

Purpose: This study reports on survival and health related quality of life (HRQOL) after extracorporeal membrane oxygenation (ECMO) treatment and the associated costs in the first year. Materials and Methods: Prospective observational cohort study patients receiving ECMO in the intensive care unit during August 2017 and July 2019. We analyzed all healthcare costs in the first year after index admission. Follow-up included a HRQOL analysis using the EQ-5D-5L at 6 and 12 months. Results: The study enrolled 428 patients with an ECMO run during their critical care admission. The one-year mortality was 50%. Follow up was available for 124 patients at 12 months. Survivors reported a favorable mean HRQOL (utility) of 0.71 (scale 0–1) at 12 months of 0.77. The overall health status (VAS, scale 0–100) was reported as 73.6 at 12 months. Mean total costs during the first year were $204,513 ± 211,590 with hospital costs as the major factor contributing to the total costs. Follow up costs were $53,752 ± 65,051 and costs of absenteeism were $7317 ± 17,036. Conclusions: At one year after hospital admission requiring ECMO the health-related quality of life is favorable with substantial costs but considering the survival might be acceptable. However, our results are limited by loss of follow up. So it may be possible that only the best-recovered patients returned their questionnaires. This potential bias might lead to higher costs and worse HRQOL in a real-life scenario. •One year costs after ICU admission with extracorporeal membrane oxygenation are high.•Hospital costs are the major factor contributing to the total costs.•Health related quality of life is favorable and comparable to the general population.