Costs associated with extracorporeal life support used in adults: A single-center study

Background: To identify predictors of the total hospital costs associated with adult extracorporeal life support (ECLS). Methods: This retrospective study included 72 adults receiving ECLS for postcardiotomy cardiogenic shock, non-postcardiotomy cardiogenic shock or arrest, and adult respiratory distress syndrome in a single institution between January 2008 and December 2009. Data pertaining to the total hospital costs borne by these patients at a single institution, including pre- and post-ECLS hospital stay and procedures, were obtained and compared for patients who received ECLS for different indications and had different outcomes. Results: Forty-six patients were weaned off ECLS, and 31 survived to hospital discharge. The mean durations of ECLS and hospital stay were 173 hours and 50 days, respectively. The 2-year survival rate was 96.3% in discharged patients without major squeal. The mean and median of the estimated total hospital costs were 39,845 USD and 39,262 USD, respectively. Personnel (41%) and blood product (8%) accounted for 50% of the total hospital costs. Calculated using the multiple linear regression, the prediction model of the ECLS-associated costs was as follows: total hospital cost (USD) = 20,514 + 314 x Total hospital stay (d) + 11,107 x In-hospital mortality - 7,343 x Non-postcardiotomy ECLS-assisted resuscitation (R ² = 0.43). Conclusion: The length of hospital stay and occurrence of in-hospital mortality were predictors of the total hospital costs associated with adult ECLS. Therefore, strategies that may contribute to the final success of ECLS, such as actively including the good-prognostic candidates, should be adopted.