• Paul E Boucher, John Taplin, and Fiona Clement.
• Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: pboucher@ucalgary.ca.
• Chest. 2022 Mar 1; 161 (3): 684-696.

BackgroundARDS is an inflammatory condition of the lungs and is a common condition in adult ICUs. The resources required and costs of care for patients with ARDS are significant because of the severity of the illness and extended ICU lengths of stay.Research QuestionWhat are the costs associated with ARDS?Study Design And MethodsWe systematically searched the literature through April 29, 2021, for articles relevant to ARDS and costs. MEDLINE, Embase, Central, and EconLit databases were searched, and articles that reported on cost data from an original publication in adult patients with ARDS were included. Two authors independently assessed articles for inclusion and extracted data elements related to costs, methodology, health care system type, economic perspective, and clinical data. Publication quality was assessed using a modified version of the Quality of Health Economic Studies Instrument.ResultsFour thousand six hundred sixty-three publications were found, of which 110 were included for full-text review (κ = 0.72). A total of 22 publications (49,483 patients) were suitable for data extraction. The publications represented a broad range of health care systems, economic perspectives, costing methodology, and time frames. Mean inpatient costs ranged from $8,476 (2021 US dollars [USD]) to $547,974 (2021 USD) and were highest in publications of lower quality and in American health systems and were associated with trauma cohorts. Outpatient costs were highest in publications with higher readmission rates, longer durations of follow-up, and in American health systems.InterpretationA wide range of costing data is available for ARDS. A comprehensive synthesis of this literature frames the reasons for this and allows estimates to reflect the context in which they were assessed. This information will be of value to researchers and administrators interested in the economics of caring for patients with ARDS.Trial RegistryPROSPERO; No.: CRD42020192487 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192487.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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