Cost Analysis From a Randomized Comparison of Immediate Versus Delayed Angiography After Cardiac Arrest

Cyril Camaro, Judith L. Bonnes, Eddy M. Adang, Eva M. Spoormans, Gladys N. Janssens, Nina W. van der Hoeven, Lucia S. Jewbali, Eric A. Dubois, Martijn Meuwissen, Tom A. Rijpstra, Hans A. Bosker, Michiel J. Blans, Gabe B. Bleeker, Remon Baak, George J. Vlachojannis, Bob J. Eikemans, Pim van der Harst, Iwan C. van der Horst, Michiel Voskuil, Joris J. van der HeijdenBert Beishuizen, Martin Stoel, Hans van der Hoeven, Jose P. Henriques, Alexander P. Vlaar, Maarten A. Vink, Bas van den Bogaard, Ton A. Heestermans, Wouter de Ruijter, Thijs S. Delnoij, Harry J. Crijns, Gillian A. Jessurun, Pranobe Oemrawsingh, Marcel T. Gosselink, Koos Plomp, Michael Magro, Paul W. Elbers, Peter M. van de Ven, Jorrit S. Lemkes, Niels van Royen*

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

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Samenvatting

BACKGROUND In patients with out-of-hospital cardiac arrest without ST-segment elevation, immediate coronary angiography did not improve clinical outcomes when compared with delayed angiography in the COACT (Coronary Angiography After Cardiac Arrest) trial. Whether 1 of the 2 strategies has benefits in terms of health care resource use and costs is currently unknown. We assess the health care resource use and costs in patients with out-of-hospital cardiac arrest.

METHODS AND RESULTS A total of 538 patients were randomly assigned to a strategy of either immediate or delayed coronary angiography. Detailed health care resource use and cost-prices were collected from the initial hospital episode. A generalized linear model and a gamma distribution were performed. Generic quality of life was measured with the RAND-36 and collected at 12-month follow-up. Overall total mean costs were similar between both groups (EUR 33 575 +/- 19 612 versus EUR 33 880 +/- 21 044; P=0.86). Generalized linear model: (beta, 0.991; 95% CI, 0.894-1.099; P=0.86). Mean procedural costs (coronary angiography and percutaneous coronary intervention, coronary artery bypass graft) were higher in the immediate angiography group (EUR 4384 +/- 3447 versus EUR 3028 +/- 4220; P

CONCLUSIONS The mean total costs between patients with out-of-hospital cardiac arrest randomly assigned to an immediate angiography or a delayed invasive strategy were similar during the initial hospital stay. With respect to the higher invasive procedure costs in the immediate group, a strategy awaiting neurological recovery followed by coronary angiography and planned revascularization may be considered.

REGISTRATION

URL: https://trialregister.nl; Unique identifier: NL4857.

Originele taal-2English
Artikelnummer022238
Aantal pagina's17
TijdschriftJournal of the American Heart Association
Volume11
Nummer van het tijdschrift5
DOI's
StatusPublished - 1-mrt.-2022

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