Imperial College London
Alternate

ProfessorStephenBrett

Faculty of Medicine, Department of Surgery & Cancer

Professor of Critical Care
 
 
 
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Contact

 

+44 (0)20 3313 4521stephen.brett Website

 
 
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Location

 

Hammersmith House 570Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stokes:2021:10.1016/j.resuscitation.2021.06.002,
author = {Stokes, E and Lazaroo, M and Clout, M and Brett, S and Black, S and Kirby, K and Nolan, J and Reeves, B and Robinson, M and Rogers, C and Scott, L and Smartt, H and South, A and Taylor, J and Thomas, M and Voss, S and Benger, J and Wordsworth, S},
doi = {10.1016/j.resuscitation.2021.06.002},
journal = {Resuscitation},
pages = {1--9},
title = {Cost-effectiveness of the i-gel supraglottic airway device compared to tracheal intubation during out-of-hospital cardiac arrest: findings from the AIRWAYS-2 randomised controlled trial},
url = {http://dx.doi.org/10.1016/j.resuscitation.2021.06.002},
volume = {167},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Aim:Optimal airway management during out-of-hospital cardiac arrest (OHCA) is uncertain. Complications from tracheal intubation (TI) may be avoided with supraglottic airway (SGA) devices. The AIRWAYS-2 cluster randomised controlled trial (ISRCTN08256118) compared the i-gel SGA with TI as the initial advanced airway management (AAM) strategy by paramedics treating adults with non-traumatic OHCA. This paper reports the trial cost-effectiveness analysis.Methods:A within-trial cost-effectiveness analysis of the i-gel compared with TI was conducted, with a 6-month time horizon, from the perspective of the UK National Health Service (NHS) and personal social services. The primary outcome measure was quality-adjusted life years (QALYs), estimated using the EQ-5D-5L questionnaire. Multilevel linear regression modelling was used to account for clustering by paramedic when combining costs and outcomes.Results:9,296 eligible patients were attended by 1,382 trial paramedics and enrolled in the AIRWAYS-2 trial (4410 TI, 4886 i-gel). Mean QALYs to 6 months were 0.03 in both groups (i-gel minus TI difference -0.0015, 95% CI –0.0059 to 0.0028). Total costs per participant up to 6 months post-OHCA were £3,570 and £3,413 in the i-gel and TI groups respectively (mean difference £157, 95% CI –£270 to £583). Based on mean difference point estimates, TI was more effective and less costly than i-gel; however differences were small and there was great uncertainty around these results.Conclusion:The small differences between groups in QALYs and costs shows no difference in the cost-effectiveness of the i-gel and TI when used as the initial AAM strategy in adults with non-traumatic OHCA.
AU  - Stokes,E
AU  - Lazaroo,M
AU  - Clout,M
AU  - Brett,S
AU  - Black,S
AU  - Kirby,K
AU  - Nolan,J
AU  - Reeves,B
AU  - Robinson,M
AU  - Rogers,C
AU  - Scott,L
AU  - Smartt,H
AU  - South,A
AU  - Taylor,J
AU  - Thomas,M
AU  - Voss,S
AU  - Benger,J
AU  - Wordsworth,S
DO  - 10.1016/j.resuscitation.2021.06.002
EP  - 9
PY  - 2021///
SN  - 0300-9572
SP  - 1
TI  - Cost-effectiveness of the i-gel supraglottic airway device compared to tracheal intubation during out-of-hospital cardiac arrest: findings from the AIRWAYS-2 randomised controlled trial
T2  - Resuscitation
UR  - http://dx.doi.org/10.1016/j.resuscitation.2021.06.002
UR  - https://www.sciencedirect.com/science/article/pii/S0300957221002239?via%3Dihub
UR  - http://hdl.handle.net/10044/1/90275
VL  - 167
ER  -
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