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01-11-2019 | Cardiogenic Shock | Original

Mortality and costs following extracorporeal membrane oxygenation in critically ill adults: a population-based cohort study

Authors: Shannon M. Fernando, Danial Qureshi, Peter Tanuseputro, Eddy Fan, Laveena Munshi, Bram Rochwerg, Robert Talarico, Damon C. Scales, Daniel Brodie, Sonny Dhanani, Anne-Marie Guerguerian, Sam D. Shemie, Kednapa Thavorn, Kwadwo Kyeremanteng

Published in: Intensive Care Medicine | Issue 11/2019

Abstract

Purpose

Extracorporeal membrane oxygenation (ECMO) is used as temporary cardiorespiratory support in critically ill patients. Little is known about population-level short- and long-term outcomes following ECMO, including healthcare use and health system cost across a wide range of sectors.

Methods

Population-based cohort study in Ontario, Canada (October 1, 2009–March 31, 2017) of adult patients (≥ 18 years) receiving ECMO for cardiorespiratory support. We captured outcomes through linkage to health administrative databases. Primary outcome was mortality during hospitalization, as well as at 7 days, 30 days, 1 year, 2 years, and 5 years following ECMO initiation. We analyzed health system costs (in Canadian dollars) in the 1 year following the date of the index admission.

Results

A total of 692 patients were included. Mean (standard deviation [SD]) age was 51.3 (16.0) years. Median (interquartile range [IQR]) time to ECMO initiation from date of admission was 2 (0–9) days. In-hospital mortality was 40.0%. Mortality at 1 year, 2 years, and 5 years was 45.1%, 49.0%, and 57.4%, respectively. Among survivors, 78.4% were discharged home, while 21.2% were discharged to continuing care. Median (IQR) total costs in the 1 year following admission among all patients were Canadian $130,157 (Canadian $58,645–Canadian $240,763), of which Canadian $91,192 (Canadian $38,507–Canadian $184,728) were attributed to inpatient care.

Conclusions

Hospital mortality among critically ill adults receiving ECMO for advanced cardiopulmonary support is relatively high, but does not markedly increase in the years following discharge. Survivors are more likely to be discharged home than to continuing care. Median costs are high, but largely reflect inpatient hospital costs, and not costs incurred following discharge.

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Title: Mortality and costs following extracorporeal membrane oxygenation in critically ill adults: a population-based cohort study
Authors: Shannon M. Fernando
Danial Qureshi
Peter Tanuseputro
Eddy Fan
Laveena Munshi
Bram Rochwerg
Robert Talarico
Damon C. Scales
Daniel Brodie
Sonny Dhanani
Anne-Marie Guerguerian
Sam D. Shemie
Kednapa Thavorn
Kwadwo Kyeremanteng
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Cardiogenic Shock
Cardiogenic Shock
Acute Respiratory Distress-Syndrome
ECMO
ECMO
Published in: Intensive Care Medicine / Issue 11/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05766-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mortality and costs following extracorporeal membrane oxygenation in critically ill adults: a population-based cohort study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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