One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure 英文参考文献.docVIP

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One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure 英文参考文献.doc

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One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure 英文参考文献

Linko et al. Critical Care 2010, 14:R60 /content/14/2/R60 RESEARCH Open Access One-year mortality, quality of life and predicted Research life-time cost-utility in critically ill patients with acute respiratory failure Rita Linko*1, Raili Suojaranta-Ylinen1, Sari Karlsson2, Esko Ruokonen3, Tero Varpula1, Ville Pettil?4 and the FINNALI study investigators Abstract Introduction: High daily intensive care unit (ICU) costs are associated with the use of mechanical ventilation (MV) to treat acute respiratory failure (ARF), and assessment of quality of life (QOL) after critical illness and cost-effectiveness analyses are warranted. Methods: Nationwide, prospective multicentre observational study in 25 Finnish ICUs. During an eight-week study period 958 consecutive adult ICU patients were treated with ventilatory support over 6 hours. Of those 958, 619 (64.6%) survived one year, of whom 288 (46.5%) answered the quality of life questionnaire (EQ-5D). We calculated EQ-5D index and predicted lifetime quality-adjusted life years (QALYs) gained using the age- and sex-matched life expectancy for survivors after one year. For expired patients the exact lifetime was used. We divided all hospital costs for all ARF patients by the number of hospital survivors, and by all predicted lifetime QALYs. We also adjusted for those who died before one year and for those with missing QOL to be able to estimate the total QALYs. Results: One-year mortality was 35% (95% CI 32 to 38%). For the 288 respondents median [IQR] EQ-5D index after one year was lower than that of the age- and sex-matched general population 0.70 [0.45 to 0.89] vs. 0.84 [0.81 to 0.88]. For these 288, the mean (SD) predicted lifetime QALYs was 15.4 (13.3). After adjustment for missing QOL the mean predicted lifetime (SD) QALYs was 11.3 (13.0) for all the 958 ARF patients. The mean estimated costs were 20.739 € per hospital survivor, and mean predicted lifetime cost-utility for all ARF patients was 1391 € per