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Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study

BACKGROUND: Organ dysfunction is common after cardiac arrest and associated with worse short-term outcome, but its impact on long-term outcome and treatment costs is unknown. METHODS: We used nationwide registry data from the intensive care units (ICU) of the five Finnish university hospitals to eva...

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Autores principales: Pekkarinen, Pirkka T., Bäcklund, Minna, Efendijev, Ilmar, Raj, Rahul, Folger, Daniel, Litonius, Erik, Laitio, Ruut, Bendel, Stepani, Hoppu, Sanna, Ala-Kokko, Tero, Reinikainen, Matti, Skrifvars, Markus B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396453/
https://www.ncbi.nlm.nih.gov/pubmed/30819234
http://dx.doi.org/10.1186/s13054-019-2359-z
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author Pekkarinen, Pirkka T.
Bäcklund, Minna
Efendijev, Ilmar
Raj, Rahul
Folger, Daniel
Litonius, Erik
Laitio, Ruut
Bendel, Stepani
Hoppu, Sanna
Ala-Kokko, Tero
Reinikainen, Matti
Skrifvars, Markus B.
author_facet Pekkarinen, Pirkka T.
Bäcklund, Minna
Efendijev, Ilmar
Raj, Rahul
Folger, Daniel
Litonius, Erik
Laitio, Ruut
Bendel, Stepani
Hoppu, Sanna
Ala-Kokko, Tero
Reinikainen, Matti
Skrifvars, Markus B.
author_sort Pekkarinen, Pirkka T.
collection PubMed
description BACKGROUND: Organ dysfunction is common after cardiac arrest and associated with worse short-term outcome, but its impact on long-term outcome and treatment costs is unknown. METHODS: We used nationwide registry data from the intensive care units (ICU) of the five Finnish university hospitals to evaluate the association of 24-h extracerebral Sequential Organ Failure Assessment (24h-EC-SOFA) score with 1-year survival and healthcare-associated costs after cardiac arrest. We included adult cardiac arrest patients treated in the participating ICUs between January 1, 2003, and December 31, 2013. We acquired the confirmed date of death from the Finnish Population Register Centre database and gross 1-year healthcare-associated costs from the hospital billing records and the database of the Finnish Social Insurance Institution. RESULTS: A total of 5814 patients were included in the study, and 2401 were alive 1 year after cardiac arrest. Median (interquartile range (IQR)) 24h-EC-SOFA score was 6 (5–8) in 1-year survivors and 7 (5–10) in non-survivors. In multivariate regression analysis, adjusting for age and prior independency in self-care, the 24h-EC-SOFA score had an odds ratio (OR) of 1.16 (95% confidence interval (CI) 1.14–1.18) per point for 1-year mortality. Median (IQR) healthcare-associated costs in the year after cardiac arrest were €47,000 (€28,000–75,000) in 1-year survivors and €12,000 (€6600–25,000) in non-survivors. In a multivariate linear regression model adjusting for age and prior independency in self-care, an increase of one point in the 24h-EC-SOFA score was associated with an increase of €170 (95% CI €150–190) in the cost per day alive in the year after cardiac arrest. In the same model, an increase of one point in the 24h-EC-SOFA score was associated with an increase of €4400 (95% CI €3300–5500) in the total healthcare-associated costs in 1-year survivors. CONCLUSIONS: Extracerebral organ dysfunction is associated with long-term outcome and gross healthcare-associated costs of ICU-treated cardiac arrest patients. It should be considered when assessing interventions to improve outcomes and optimize the use of resources in these patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-019-2359-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-63964532019-03-11 Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study Pekkarinen, Pirkka T. Bäcklund, Minna Efendijev, Ilmar Raj, Rahul Folger, Daniel Litonius, Erik Laitio, Ruut Bendel, Stepani Hoppu, Sanna Ala-Kokko, Tero Reinikainen, Matti Skrifvars, Markus B. Crit Care Research BACKGROUND: Organ dysfunction is common after cardiac arrest and associated with worse short-term outcome, but its impact on long-term outcome and treatment costs is unknown. METHODS: We used nationwide registry data from the intensive care units (ICU) of the five Finnish university hospitals to evaluate the association of 24-h extracerebral Sequential Organ Failure Assessment (24h-EC-SOFA) score with 1-year survival and healthcare-associated costs after cardiac arrest. We included adult cardiac arrest patients treated in the participating ICUs between January 1, 2003, and December 31, 2013. We acquired the confirmed date of death from the Finnish Population Register Centre database and gross 1-year healthcare-associated costs from the hospital billing records and the database of the Finnish Social Insurance Institution. RESULTS: A total of 5814 patients were included in the study, and 2401 were alive 1 year after cardiac arrest. Median (interquartile range (IQR)) 24h-EC-SOFA score was 6 (5–8) in 1-year survivors and 7 (5–10) in non-survivors. In multivariate regression analysis, adjusting for age and prior independency in self-care, the 24h-EC-SOFA score had an odds ratio (OR) of 1.16 (95% confidence interval (CI) 1.14–1.18) per point for 1-year mortality. Median (IQR) healthcare-associated costs in the year after cardiac arrest were €47,000 (€28,000–75,000) in 1-year survivors and €12,000 (€6600–25,000) in non-survivors. In a multivariate linear regression model adjusting for age and prior independency in self-care, an increase of one point in the 24h-EC-SOFA score was associated with an increase of €170 (95% CI €150–190) in the cost per day alive in the year after cardiac arrest. In the same model, an increase of one point in the 24h-EC-SOFA score was associated with an increase of €4400 (95% CI €3300–5500) in the total healthcare-associated costs in 1-year survivors. CONCLUSIONS: Extracerebral organ dysfunction is associated with long-term outcome and gross healthcare-associated costs of ICU-treated cardiac arrest patients. It should be considered when assessing interventions to improve outcomes and optimize the use of resources in these patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-019-2359-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-28 /pmc/articles/PMC6396453/ /pubmed/30819234 http://dx.doi.org/10.1186/s13054-019-2359-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pekkarinen, Pirkka T.
Bäcklund, Minna
Efendijev, Ilmar
Raj, Rahul
Folger, Daniel
Litonius, Erik
Laitio, Ruut
Bendel, Stepani
Hoppu, Sanna
Ala-Kokko, Tero
Reinikainen, Matti
Skrifvars, Markus B.
Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title_full Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title_fullStr Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title_full_unstemmed Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title_short Association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
title_sort association of extracerebral organ failure with 1-year survival and healthcare-associated costs after cardiac arrest: an observational database study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396453/
https://www.ncbi.nlm.nih.gov/pubmed/30819234
http://dx.doi.org/10.1186/s13054-019-2359-z
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