Cost-Effectiveness of In-Bed Cycling and Routine Physiotherapy for Patients Receiving Mechanical Ventilation.

Area of Science:

• Critical Care Medicine
• Health Economics
• Rehabilitation

Background:

• The cost-effectiveness of early in-bed cycling for mechanically ventilated ICU patients is unknown.
• Usual physiotherapy is standard care, but its optimal adjuncts require evaluation.

Purpose of the Study:

• To evaluate the cost-effectiveness of early in-bed cycling plus usual physiotherapy versus usual physiotherapy alone.
• This analysis was conducted alongside the Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) randomized clinical trial.

Main Methods:

• A trial-based economic evaluation from a societal perspective over a 90-day horizon.
• Compared early in-bed cycling (within 4 days of ventilation) with usual physiotherapy in adult ICU patients.
• Calculated differences in costs (2024 Canadian dollars) and quality-adjusted life-years (QALYs).

Main Results:

• Recruited 360 patients; mean age 61.5 years, 56.9% male.
• Early in-bed cycling costs were minimal (0.5% of hospitalization costs).
• No statistically significant differences in 90-day costs (CA$5841) or QALYs (-0.0009) were observed between groups.

Conclusions:

• Adding early in-bed cycling to usual physiotherapy did not significantly alter costs or QALYs in mechanically ventilated ICU patients.
• Results suggest that further cost-effectiveness studies are warranted, considering the broader evidence base for in-bed cycling in critical care.