REDUCTION IN COSTS, BLOOD PRODUCTS, AND OPERATING TIME IN PATIENTS UNDERGOING OPEN-HEART-SURGERY

Objective: To test the hypothesis that use of aprotinin at half dose w ould be more cost-effective or as efficacious as full-dose aprotinin o r no aprotinin during open heart surgery. Design: Cost-effective analy sis, unmasked prospective comparison; Setting: Community hospital. Pat ients: One hundred thirty-three patients undergoing open heart surgery . Interventions: Patients in 3 consecutive groups undergoing open hear t surgery were allocated to receive no aprotinin, full-dose aprotinin, or half-dose aprotinin. Main Outcome Measures Total cost (in dollars) of blood products administered plus cost of aprotinin at various dosa ges, comparison of total blood products administered during hospitaliz ation, and closure time required in the operating room. Results: Full- dose and half-dose aprotinin significantly (P<.05) reduced the total b lood products administered during hospitalization and the operating ro om closure time. However, use of half-dose aprotinin resulted in a sig nificant cost savings (P<.05) when compared with either the cost of bl ood products required in the nodose aprotinin group or the cost of blo od products plus aprotinin in the full-dose aprotinin group. Conclusio n: Use of aprotinin al half dose in a community hospital resulted in a significant reduction in costs, blood product use, and operating room closure time in patients undergoing open heart surgery.