Therapeutic hypothermia following cardiac arrest associated with cost-effectiveness

Therapeutic hypothermia used in patients following a cardiac arrest not only had benefits for clinical outcomes but was also cost-effective.

Researchers developed a decision model designed to capture costs and outcomes associated with care following a cardiac arrest both with and without therapeutic hypothermia. They examined a hypothetical cohort of 100 patients who received either therapeutic hypothermia using a cooling blanket or who received conventional therapy following cardiac arrest and then followed them for six months. Incremental cost-effectiveness and quality-adjusted life years were measured using the researchers’ model.

According to the study results, patients with witnessed ventricular fibrillation and out-of-hospital cardiac arrest treated with therapeutic hypothermia gained 0.66 quality-adjusted life years (95% CI, 0.11-1.3) at an incremental cost of $31,254 (95% CI, –$5,581 to $77,553) vs. those who received conventional therapy, yielding a cost-effectiveness ratio of $47,168 (95% CI, –$16,673-$191,369) per quality-adjusted life year. Costs associated with therapeutic hypothermia and rewarming accounted for 1% of the total costs attributed to patients in the hypothermia cohort of the model, whereas post-hypothermia in-hospital and post-discharge care accounted for 99% of the total cost.

“We demonstrated that therapeutic hypothermia with cooling blanket technique in witnessed, ventricular fibrillation, out-of-hospital cardiac arrest is an acceptable investment of health care dollars and has an incremental cost-effectiveness ratio of $47,168 per quality-adjusted life year,” the researchers concluded. “From a societal perspective, post-arrest hypothermia produces benefits that justify its costs.”

Merchant RM. Circulation: Cardiovascular Quality and Outcomes. 2009;doi:10.1161/CIRCOUTCOMES.108.839605.