Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator

Berdowski, Jocelyn; Kuiper, Mathijs J.; Dijkgraaf, Marcel G.W.; Tijssen, Jan G.P.; Koster, Rudolph W.

doi:10.1016/j.resuscitation.2010.04.013

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Volume 81, Issue 8 , Pages 962-967, August 2010

Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator☆

Jocelyn Berdowski
- Department of Cardiology, Academic Medical Centre – University of Amsterdam, Amsterdam, The Netherlands
- Corresponding author at: Department of Cardiology, Academic Medical Centre – University of Amsterdam, Room F3-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. Tel.: +31 20 5665969; fax: +31 20 5669248.
Mathijs J. Kuiper
- Department of Cardiology, Academic Medical Centre – University of Amsterdam, Amsterdam, The Netherlands
Marcel G.W. Dijkgraaf
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre – University of Amsterdam, Amsterdam, The Netherlands
Jan G.P. Tijssen
- Department of Cardiology, Academic Medical Centre – University of Amsterdam, Amsterdam, The Netherlands
Rudolph W. Koster
- Department of Cardiology, Academic Medical Centre – University of Amsterdam, Amsterdam, The Netherlands

Received 9 December 2009; received in revised form 10 March 2010; accepted 13 April 2010. published online 04 June 2010.

Abstract

Background

This study aimed to determine whether automated external defibrillator (AED) use during resuscitation is associated with lower in-hospital health care costs.

Methods

For this observational prospective study, we included all treated out-of-hospital cardiac arrests of suspected cardiac cause. Clinical, survival and cost data were collected from July 2005 until March 2008. Cost data were based on hospital transport, duration of admission in hospital wards, diagnostics and interventions. We divided the study population in three groups based on AED use: (1) onsite AED, (2) dispatched AED, (3) no AED. The endpoint was survival to discharge. P<0.05 is indicated by *.

Results

Of the 2126 included patients, 136 were treated with an onsite AED, 365 with a dispatched AED and 1625 without AED. Overall (95% confidence interval [CI]) survival rate was 43% (35–51%), 16% (13–20%) and 14% (12–16%), respectively*. Per 100 survivors, the mean duration admitted at intensive care unit [ICU] were 267 (166–374), 495 (344–658), and 537 (450–609) days, respectively*; total duration of hospital admission was 2188 (1800–2594), 3132 (2573–3797), and 2765 (2519–3050) days, respectively*. Mean costs per survivor for hospital stay were €9233 (€7351–€11,280), €14,194 (€11,656–€17,254), and €13,693 (€12,226–€15,166), respectively*; total health care costs were €29,575 (€24,695–€34,183), €34,533 (€29,832–€39,487) and €31,772 (€29,217–€34,385), respectively. For both survivors and non-survivors, total costs per patient were €14,727 (€11,957–€18,324), €7703 (€6141–€9366) and €6580 (€5875–€7238), respectively*.

Conclusions

Onsite AED use was associated with higher survival rates. Surviving patients of the onsite AED group had lower total costs, mainly due to the shorter ICU stay.

Keywords: Automated external defibrillator (AED), Emergency medical services, Cost, Out-of-hospital CPR, Outcome, Cardiac arrest, Defibrillation, Europe, Resuscitation

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☆ A Spanish translated version of the summary of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2010.04.013.

PII: S0300-9572(10)00241-8

doi:10.1016/j.resuscitation.2010.04.013

« Previous Next »Resuscitation
Volume 81, Issue 8 , Pages 962-967, August 2010

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