• Murtaza I Bharmal, Joseph M Venturini, Rhys F M Chua, Willard W Sharp, David G Beiser, Corey E Tabit, Taishi Hirai, Jonathan R Rosenberg, Janet Friant, BlairJohn E AJEADepartment of Medicine, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL, 60637, United States., Jonathan D Paul, Sandeep Nathan, and Atman P Shah.
• Department of Medicine, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL, 60637, United States. Electronic address: murtaza.bharmal@uchospitals.edu.
• Resuscitation. 2019 Mar 1; 136: 126130126-130.

BackgroundExtracorporeal cardiopulmonary resuscitation (ECPR) is a resource-intensive tool that provides haemodynamic and respiratory support in patients who have suffered cardiac arrest. In this study, we investigated the cost-utility of ECPR (cost/QALY) in cardiac arrest patients treated at our institution.MethodsWe performed a retrospective review of patients who received ECPR following cardiac arrest between 2012 and 2018. All medical care-associated charges with ECPR and subsequent hospital admission were recorded. The quality-of-life of survivors was assessed with the Health Utilities Index Mark II. The cost-utility of ECPR was calculated with cost and quality-of-life data.ResultsECPR was used in 32 patients (15/32 in-hospital, 47%) with a median age of 55.0 years (IQR 46.3-63.3 years), 59% male and 66% African American. The median duration of ECPR support was 2.1 days (IQR 0.9-3.8 days). Survival to hospital discharge was 16%. The median score of the Health Utilities Index Mark II at discharge for the survivors was 0.44 (IQR 0.32-0.52). The median operating cost for patients undergoing ECMO was $125,683 per patient (IQR $49,751-$206,341 per patient). The calculated cost-utility for ECPR was $56,156/QALY gained.ConclusionsThe calculated cost-utility is within the threshold considered cost-effective in the United States (<$150,000/QALY gained). These results are comparable to the cost-effectiveness of heart transplantation for end-stage heart failure. Larger studies are needed to assess the cost-utility of ECPR and to identify whether other factors, such as patient characteristics, affect the cost-utility benefit.Copyright © 2019 Elsevier B.V. All rights reserved.

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