INTRAOPERATIVE HEMODILUTION IS MORE COST-EFFECTIVE THAN PREOPERATIVE AUTOLOGOUS DONATION FOR PATIENTS UNDERGOING PROCEDURES ASSOCIATED WITHA LOW-RISK FOR TRANSFUSION
Ma. Rosenblatt et al., INTRAOPERATIVE HEMODILUTION IS MORE COST-EFFECTIVE THAN PREOPERATIVE AUTOLOGOUS DONATION FOR PATIENTS UNDERGOING PROCEDURES ASSOCIATED WITHA LOW-RISK FOR TRANSFUSION, Journal of clinical anesthesia, 9(1), 1997, pp. 26-29
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.