INTRAOPERATIVE HEMODILUTION IS MORE COST-EFFECTIVE THAN PREOPERATIVE AUTOLOGOUS DONATION FOR PATIENTS UNDERGOING PROCEDURES ASSOCIATED WITHA LOW-RISK FOR TRANSFUSION

Study Objective: To determine the utilization and cost of autologous b lood that was donated preoperatively, and Co compare it to the cost of employing intraoperative hemodilution to provide autologous blood for patients undergoing surgical procedures with a low risk for the need for transfusion. Design: Retrospective chart review. Setting: Universi ty medical center. Patients: All ASA physical status I and II patients who underwent nononcologic gynecologic procedures and preoperatively donated autologous blood between July 1993 and June 1994. Measurements and Main Results: The utilization and overall cost of predonated auto logous blood was determined. The cost for employing intraoperative hem odilution and potential cost saving was then calculated. Of the 234 un its of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 mi, 32 un its returned to patients who had an estimated blood loss less than 500 mi, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blo od was $23,274.62. Employing hemodilution for those same patients woul d have cost $5,574.74, and resulted in a potential 75.4% savings. Conc lusions: Inappropriate selection of patients for preoperative blood do nation is costly. For those patients scheduled to undergo surgical pro cedures associated with a low probability for the need for blood trans fusion, but who desire that autologous blood be available, hemodilutio n provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and afford ing substantial cost savings. (C) 1997 Elsevier Science Inc.