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Observational Study
. 2023 Feb:73:154215.
doi: 10.1016/j.jcrc.2022.154215. Epub 2022 Nov 17.

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

Annemieke Oude Lansink-Hartgring  1 , Dinis Dos Reis Miranda  2 , Loes Mandigers  2 , Thijs Delnoij  3 , Roberto Lorusso  4 , Jacinta J Maas  5 , Carlos V Elzo Kraemer  5 , Alexander P J Vlaar  6 , S Jorinde Raasveld  6 , Dirk W Donker  7 , Erik Scholten  8 , Anja Balzereit  9 , Judith van den Brule  10 , Marijn Kuijpers  11 , Karin M Vermeulen  12 , Walter M van den Bergh  13 ; Dutch ECLS Study group
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Free article
Observational Study

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

Annemieke Oude Lansink-Hartgring et al. J Crit Care. 2023 Feb.
Free article

Abstract

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.

Keywords: Cost analysis; Critical care; Extracorporeal life support; Hospital costs; Outcome; Quality of life.

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Conflict of interest statement

Declaration of Competing Interest Dirk W. Donker received speaker fee from Getinge-Maquet and Xenios NovaLung Fresenius. Dirk W. Donker has research cooperation's with Getinge-Maquet and Xenios NovaLung Fresenius. Roberto Lorusso is consultant for Medtronic, LivaNova, and Getinge. He is part of the Medical Advisory Board of Eurosets and Xenios. All honoraria are paid to the university for research funding. Dinis dos Reis Miranda received speaking fees from Xenios. The remaining authors have disclosed that they do not have any conflicts of interest.

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