Health Care Costs after Cardiac Arrest in the United States

Abdulla A. Damluji, Mohammed S. Al-Damluji, Sydney Pomenti, Tony J. Zhang, Mauricio G Cohen, Raul Mitrani, Mauro Moscucci, Robert J Myerburg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: This study was designed to estimate the costs of index hospitalizations after cardiac arrest in the United States. Methods and Results: We used the US Nationwide Inpatient Sample (2003-2012) to identify patients with cardiac arrest. Log transformation of inflation-adjusted cost was determined for care to patient outcomes. Overall, an estimated 1 387 396 patients were hospitalized after cardiac arrest. The mean age of the cohort was 66 years, 45% were women, and the majority were white. Inpatient procedures included coronary angiography (15%), percutaneous coronary intervention (7%), intra-aortic balloon pump (4.4%), therapeutic hypothermia (1.1%), and mechanical circulatory support (0.1%). The rates of therapeutic hypothermia increased from zero in 2003 to 2.7% in 2012 (P<0.001). Both hospital charges and inflation-adjusted cost increased linearly over time. In a multivariate analysis, predictors of inflation-adjusted cost included large hospital size, urban teaching hospital, and length of stay. Among comorbidities, atrial fibrillation or fluid and electrolytes imbalance was most associated with cost. Among selected interventions, the cost was significantly increased with automatic implantable cardioverter defibrillators (odds ratio, 1.83; P<0.001), intra-aortic balloon pump (odds ratio, 1.50; P<0.001), hypothermia (odds ratio, 1.28; P<0.001), and extracorporeal membrane oxygenation (odds ratio, 2.38; P<0.001). Conclusions: In the period between 2003 and 2012, postcardiac arrest hospitalizations resulted in a steady rise in associated health care cost, likely related to increased length of stay, medical procedures, and systems of care. Although targeted cost containment for postarrest interventions may reduce the finance burden, there is an increasing need for funding research into prediction and prevention of cardiac arrest, which offers greater societal benefit.

Original languageEnglish (US)
Article numbere005689
JournalCirculation: Arrhythmia and Electrophysiology
Volume11
Issue number4
DOIs
StatePublished - Apr 1 2018
Externally publishedYes

Fingerprint

Heart Arrest
Health Care Costs
Costs and Cost Analysis
Economic Inflation
Odds Ratio
Induced Hypothermia
Length of Stay
Inpatients
Hospitalization
Health Facility Size
Hospital Charges
Extracorporeal Membrane Oxygenation
Cost Control
Implantable Defibrillators
Urban Hospitals
Percutaneous Coronary Intervention
Hypothermia
Coronary Angiography
Teaching Hospitals
Atrial Fibrillation

Keywords

  • cost-benefit analysis
  • heart arrest
  • hospital charges
  • length of stay
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Health Care Costs after Cardiac Arrest in the United States. / Damluji, Abdulla A.; Al-Damluji, Mohammed S.; Pomenti, Sydney; Zhang, Tony J.; Cohen, Mauricio G; Mitrani, Raul; Moscucci, Mauro; Myerburg, Robert J.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 11, No. 4, e005689, 01.04.2018.

Research output: Contribution to journalArticle

Damluji, Abdulla A. ; Al-Damluji, Mohammed S. ; Pomenti, Sydney ; Zhang, Tony J. ; Cohen, Mauricio G ; Mitrani, Raul ; Moscucci, Mauro ; Myerburg, Robert J. / Health Care Costs after Cardiac Arrest in the United States. In: Circulation: Arrhythmia and Electrophysiology. 2018 ; Vol. 11, No. 4.
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AB - Background: This study was designed to estimate the costs of index hospitalizations after cardiac arrest in the United States. Methods and Results: We used the US Nationwide Inpatient Sample (2003-2012) to identify patients with cardiac arrest. Log transformation of inflation-adjusted cost was determined for care to patient outcomes. Overall, an estimated 1 387 396 patients were hospitalized after cardiac arrest. The mean age of the cohort was 66 years, 45% were women, and the majority were white. Inpatient procedures included coronary angiography (15%), percutaneous coronary intervention (7%), intra-aortic balloon pump (4.4%), therapeutic hypothermia (1.1%), and mechanical circulatory support (0.1%). The rates of therapeutic hypothermia increased from zero in 2003 to 2.7% in 2012 (P<0.001). Both hospital charges and inflation-adjusted cost increased linearly over time. In a multivariate analysis, predictors of inflation-adjusted cost included large hospital size, urban teaching hospital, and length of stay. Among comorbidities, atrial fibrillation or fluid and electrolytes imbalance was most associated with cost. Among selected interventions, the cost was significantly increased with automatic implantable cardioverter defibrillators (odds ratio, 1.83; P<0.001), intra-aortic balloon pump (odds ratio, 1.50; P<0.001), hypothermia (odds ratio, 1.28; P<0.001), and extracorporeal membrane oxygenation (odds ratio, 2.38; P<0.001). Conclusions: In the period between 2003 and 2012, postcardiac arrest hospitalizations resulted in a steady rise in associated health care cost, likely related to increased length of stay, medical procedures, and systems of care. Although targeted cost containment for postarrest interventions may reduce the finance burden, there is an increasing need for funding research into prediction and prevention of cardiac arrest, which offers greater societal benefit.

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