Real-world cost-effectiveness of targeted temperature management in out-of-hospital cardiac arrest survivors: results from an academic medical center  

作　　者：Wachira Wongtanasarasin Daniel K.Nishijima Wanrudee Isaranuwatchai Jeff rey S.Hoch 

机构地区：[1]Department of Emergency Medicine,Faculty of Medicine,Chiang Mai University,Chiang Mai 50200,Thailand [2]Department of Emergency Medicine,University of California Davis School of Medicine,Sacramento 95817,USA [3]Health Intervention and Technology Assessment Program,Ministry of Public Health,Bangkok 11000,Thailand [4]Institute of Health Policy,Management and Evaluation,University of Toronto,Toronto M5T 3M6,Canada [5]Division of Health Policy and Management,Department of Public Health Sciences,University of California Davis School of Medicine,Sacramento 95817,USA [6]Center for Healthcare Policy and Research,University of California Davis School of Medicine,Sacramento 95817,USA

出　　处：《World Journal of Emergency Medicine》2025年第1期28-34,共7页世界急诊医学杂志(英文)

基　　金：supported by Faculty of Medicine;Chiang Mai University;supported by the National Center for Advancing Translational Sciences;National Institutes of Health;through grant number UL1 TR001860. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH。

摘　　要：BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level data.METHODS: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 January, 2019 and 30 June, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ellipse.RESULTS: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness plane.CONCLUSION: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.

关 键 词：Out-of-hospital cardiac arrest Targeted temperature management COST-EFFECTIVENESS SURVIVAL Real-world data 

分 类 号：R541.78[医药卫生—心血管疾病]