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Updated: Jul 3, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Cost-utility analysis of the British Cardiovascular Interventional Society conveyance algorithm for patients with

Guilherme Movio1, Uzma Sajjad1, Rupert Simpson1

  • 1Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, United Kingdom; Anglia Ruskin School of Medicine & MTRC, Chelmsford, United Kingdom.

Resuscitation
|February 20, 2026
PubMed

Insights

Implementing a new cardiac arrest algorithm for out-of-hospital cardiac arrest patients is cost-effective. This strategy improves resource efficiency and shows a high probability of cost-effectiveness at standard willingness-to-pay thresholds.

Area of Science:

  • Cardiology
  • Health Economics
  • Public Health

Background:

  • Out-of-hospital cardiac arrest (OHCA) presents significant mortality and healthcare burdens.
  • The British Cardiovascular Interventional Society's conveyance algorithm directs shockable rhythm patients to specialized Cardiac Arrest Centres for advanced care.
  • This study assessed the economic impact of implementing this algorithm in a large region.

Purpose of the Study:

  • To evaluate the cost-effectiveness of the British Cardiovascular Interventional Society's conveyance algorithm.
  • To compare the algorithm's economic impact against standard care over a lifetime horizon.

Main Methods:

  • A hybrid decision-analytic model (decision tree and Markov model) was employed.
  • Data were sourced from a contemporary observational pilot study.
  • Health outcomes (quality-adjusted life years) and costs were analyzed, with costs discounted at 3.5% annually.

Main Results:

  • The conveyance algorithm demonstrated cost-effectiveness with an incremental cost-effectiveness ratio of £2,926 per quality-adjusted life year gained.
  • Cost savings in intensive care, hospital wards, and ambulance services were observed, slightly offset by increased admission and longer-term care costs.
  • Probabilistic analysis indicated an 86.0% likelihood of cost-effectiveness at a £35,000 per quality-adjusted life year willingness-to-pay threshold.

Conclusions:

  • Selective, rhythm-based transfer to Cardiac Arrest Centres enhances resource efficiency with minimal added cost.
  • While clinical outcomes require further investigation due to observational data limitations, the economic evaluation supports broader clinical and health system benefit studies.
  • Further prospective, multi-centre research is recommended to validate these findings.
Abstract

Keywords:
British Cardiovascular Interventional SocietyDecision treeEconomic evaluationMarkov modelOHCA conveyance algorithmOut-of-hospital cardiac arrest

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