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Cardiopulmonary resuscitation: what cost to cheat death?
K H Lee1, D C Angus, N S Abramson
1Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh, PA 15213, USA.
Insights
Cardiopulmonary resuscitation (CPR) outcomes vary widely, influenced by patient factors and treatment. While CPR can be life-saving, its widespread application is very expensive, with high costs per life saved or quality-adjusted life-year.
Area of Science:
- Health Economics
- Emergency Medicine
- Critical Care
Background:
- Outcomes of cardiopulmonary resuscitation (CPR) are highly variable.
- Factors influencing CPR success include patient condition, cardiac rhythm, and timeliness of intervention.
- Cost-analysis of CPR programs is complex due to resource variation and patient-specific outcomes.
Purpose of the Study:
- To review CPR outcomes, influencing factors, associated costs, and cost-analysis applications.
- To evaluate the cost-effectiveness of CPR programs.
Main Methods:
- Systematic review of published literature and ongoing research.
- MEDLINE keyword searches for CPR and cost-analysis relevance.
- Extraction of applicable data from English-language publications.
Main Results:
- Cost-effectiveness estimates for CPR programs range from $344,314 to $966,759 per life saved.
- Quality-adjusted life-year costs range from $191,286 to $537,088.
- CPR outcomes range from full recovery to 100% mortality.
Conclusions:
- Appropriate CPR is recommended, but its broad implementation is costly.
- Patient-specific factors significantly impact CPR cost-effectiveness.
- Further research is needed to optimize CPR resource allocation.
Objectives:
To review the various outcomes from cardiopulmonary resuscitation (CPR), the factors that influence these outcomes, the costs associated with CPR, and the application of cost-analyses to CPR.
Data Sources:
Data used to prepare this article were drawn from published articles and work in progress.
Study Selection:
Articles were selected for their relevance to the subjects of CPR and cost-analysis by MEDLINE keyword search.
Data Extraction:
The authors extracted all applicable data from the English literature.
Data Synthesis:
Cost-analysis studies of CPR programs are limited by the high variation in resources consumed and attribution of cost to these resources. Furthermore, cost projections have not been adjusted to reflect patient-dependent variation in outcome. Variation in the patient's underlying condition, presenting cardiac rhythm, time to provision of definitive CPR, and effective perfusion all influence final outcome and, consequently, influence the cost-effectiveness of CPR programs. Based on cost data from previous studies, preliminary estimates of the cost-effectiveness of CPR programs for all 6-month survivors of a large international multicenter collaborative trial are $406,605.00 per life saved (range $344,314.00 to $966,759.00), and $225,892.00 per quality-adjusted-life-year (range $191,286.00 to $537,088.00).
Conclusions:
Reported outcome from CPR has varied from reasonable rates of good recovery, including return to full employment to 100% mortality. Appropriate CPR is encouraged, but continued widespread application appears extremely expensive.
Related Concept Videos
Introduction Cardiac Emergencies
Cardiopulmonary Resuscitation I: Adult
Cardiopulmonary Resuscitation II: ACLS Airway Management
Cardiopulmonary Resuscitation III: AED Use
Cardiopulmonary Resuscitation IV: Pharmacological Management
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

