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Hypothermia for perinatal asphyxia: trial-based resource use and costs at 6textendash7 years

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Oliver Rivero-Arias, Oya Eddama, Denis Azzopardi, A David Edwards, Brenda Strohm, Helen Campbell

Original languageEnglish
JournalArchives of Disease in Childhood Fetal and Neonatal Edition
Early online date11 Jul 2018
DOIs
Publication statusE-pub ahead of print - 11 Jul 2018

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Abstract

Objective To assess the impact of hypothermic neural rescue for perinatal asphyxia at birth on healthcare costs of survivors aged 6textendash7 years, and to quantify the relationship between costs and overall disability levels.Design 6textendash7 years follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.Setting Community study including a single parental questionnaire to collect information on children's healthcare resource use.Patients 130 UK children (63 in the control group, 67 in the hypothermia group) whose parents consented and returned the questionnaire.Interventions Intensive care with cooling of the body to 33.5textdegreeC for 72 hours or intensive care alone.Main outcome measures Healthcare resource usage and costs over the preceding 6 months.Results At 6textendash7 years, mean (SE) healthcare costs per child were textsterling1543 (textsterling361) in the hypothermia group and textsterling2549 (textsterling812) in the control group, giving a saving of -textsterling1005 (95% CI -textsterling2734 to textsterling724). Greater levels of overall disability were associated with progressively higher costs, and more parents in the hypothermia group were employed (64% vs 47. Results were sensitive to outlying observations.Conclusions Cost results although not significant favoured moderate hypothermia and so complement the clinical results of the TOBY Children study. Estimates were however sensitive to the care requirements of two seriously ill children in the control group. A quantification of the relationship between costs and levels of disability experienced will be useful to healthcare professionals, policy makers and health economists contemplating the long-term economic consequences of perinatal asphyxia and hypothermic neural rescue.Trial registration number This study reports on the follow-up of the TOBY clinical trial: ClinicalTrials. gov number NCT01092637.

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