ECONOMIC-IMPACT OF INAPPROPRIATE BLOOD-TRANSFUSIONS IN CORONARY-ARTERY BYPASS GRAFT-SURGERY

PURPOSE: In addition to historically important issues of blood invento ry and blood safety, the costs of blood transfusion are anticipated to have an increasingly important impact on transfusion practices. To ad dress this, we analyzed costs of blood support given to patients under going coronary artery bypass graft (CABG) surgery, along with costs of blood components whose transfusions were identified to be unnecessary . PATIENTS AND METHODS: Blood components transfused as part of a previ ously reported national, multicenter audit of 30 adult patients each a t 18 institutions undergoing primary, elective CABG surgery were revie wed. RESULTS. The range of blood purchase costs among institutions was broad, varying over two-fold. The range of red cell units transfused varied over 10-fold, and the range of total components transfused vari ed over 40-fold. The number of blood components transfused unnecessari ly represented 27% of all blood units transfused, ranging from 7% to 4 3% among institutions. Inappropriate transfusions accounted for 47%, 3 2%, and 15% of all platelet, plasma, and red cell units transfused. Th e mean institutional cost for all blood components transfused per pati ent was $397 +/- $244. The cost per patient of components transfused i nappropriately was 24% of this, or $96 +/- $89 (mean +/- SD). CONCLUSI ON: These costs could be reduced with practice guidelines and quality improvement programs aimed at reducing the number of inappropriate tra nsfusions.