Abstract P79: Onsite Automated External Defibrillators Increase Survival and Lower Health Care Costs Until Hospital Discharge for Survivors
Background-This study aimed to determine whether AED use during out-of-hospital cardiac arrest(OHCA) is associated with lower in-hospital health care costs.
Methods-In this observational prospective study, we included all resuscitated patients (pts) with a non-traumatic OHCA. 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 excluded ambulance witnessed arrests and patients lost to follow up. The primary outcome was survival until discharge. We divided the study population in three groups based on AED use:
dispatched AED used by policeman or firefighter,
no AED use.
Differences in costs were assessed after non-parametric bootstrapping. All costs were expressed in Euros.
Results-136 Pts were treated with an onsite AED, 365 with a dispatched AED and 1625 without an AED. Mean (95% confidence interval [CI]) overall survival rate was 43% (35%–51%) 16% (13%–20%) and 14% (12%–16%), respectively. Mean (95%CI) total health care costs were 14727 (11957–18324), 7703 (6141–9365) and 6580 (5875–7238), respectively. Per survivor, mean stay at the intensive care unit was 3, 5 and 5 days; total duration of admission was 22, 31 and 28 days respectively. Costs per survivor and per non-survivor are shown in Table 1⇓. The willingness to pay per hospital survivor should at least be E33602 for onsite AED use to become more efficient than no AED usage in 75% of all OHCA cases. For dispatched AED use compared to no AED use, this willingness-to-pay value was E78571.
Conclusions-Compared with dispatched AED use and no AED use, onsite AED use is attractive and associated with a two- to three-fold increase of hospital survival at about a doubling of the costs of health care during the first 90 days following cardiac arrest. Surviving pts with onsite AED use showed the lowest total costs, mainly due to a shorter duration of hospital admission.