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

Annemieke Oude Lansink-Hartgring*, Dinis Dos Reis Miranda, Loes Mandigers, Thijs Delnoij, Roberto Lorusso, Jacinta J Maas, Carlos V Elzo Kraemer, Alexander P J Vlaar, S Jorinde Raasveld, Dirk W Donker, Erik Scholten, Anja Balzereit, Judith van den Brule, Marijn Kuijpers, Karin M Vermeulen, Walter M van den Bergh, Dutch ECLS Study group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Article number154215
Number of pages7
JournalJournal of Critical Care
Volume73
Issue number1
Early online date16 Nov 2022
DOIs
Publication statusPublished - Feb 2023

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