Impact of mechanical ventilation on the daily costs of ICU care: a systematic review and meta regression. (5th December 2019)

• Record Type: Journal Article
• Authors: Kaier, Klaus; Heister, Thomas; Motschall, Edith; Hehn, Philip; Bluhmki, Tobias; Wolkewitz, Martin
• Is Part Of: Epidemiology and infection. Volume 147(2019)
• Publication Date: 2019-12-05
• Subjects: Added costs, -- ICU costs, -- mechanical ventilation, -- review, -- ventilator-associated pneumonia; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268819001900
• Languages: English
• ISSNs: 0950-2688

Abstract

Abstract: The impact of mechanical ventilation on the daily costs of intensive care unit (ICU) care is largely unknown. We thus conducted a systematic search for studies measuring the daily costs of ICU stays for general populations of adults (age ≥18 years) and the added costs of mechanical ventilation. The relative increase in the daily costs was estimated using random effects meta regression. The results of the analyses were applied to a recent study calculating the excess length-of-stay associated with ICU-acquired (ventilator-associated) pneumonia, a major complication of mechanical ventilation. The search identified five eligible studies including a total of 54 766 patients and ~238 037 patient days in the ICU. Overall, mechanical ventilation was associated with a 25.8% (95% CI 4.7%–51.2%) increase in the daily costs of ICU care. A combination of these estimates with standardised unit costs results in approximate daily costs of a single ventilated ICU day of €1654 and €1580 in France and Germany, respectively. Mechanical ventilation is a major driver of ICU costs and should be taken into account when measuring the financial burden of adverse events in ICU settings.