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  1. Intraoperative salvage in patients undergoing elective abdominal aortic aneurysm repair : An analysis of cost and benefit.

    Article - En anglais

    Purpose 

    Although autologous blood procurement has become a standard of care in elective surgery, recent studies have questioned its cost-effectiveness.

    We therefore reviewed our 3-year experience with intraoperative cell salvage in patients who underwent elective abdominal aortic aneurysm repair.

    Methods 

    A 3-year retrospective chart review of elective abdominal aortic aneurysm (infrarenal and suprarenal) repair was performed.

    Transthoracic repairs were excluded.

    Results 

    Estimated blood lost was 1748 ± 1236 ml, or 35% of baseline blood volume (5012 ± 689 ml).

    Overall, 164 (89%) received red blood cell (RBC) transfusions (3.5 ± 2.0 U/patient).

    The cost per patient for cell salvage was $315 ± $97, representing 31% of all RBC costs and 24% of total blood component costs.

    Mean salvage volume infused was 578 ± 600 ml ; at a mean hematocrit level of 55.7% the RBC volume infused from salvage during surgery was 313 ± 328 ml (representing 27% of total RBC volume lost during the hospital stay).

    This mean RBC volume salvaged represented the equivalent of 1.6 blood bank RBC units.

    The mean blood bank costs saved by using cell salvage was $248, or 79% of the $315 actually spent for salvage.

    We found no decrease in percentage of patients undergoing transfusion until salvage volumes that were infused exceeded 750 ml, or the equivalent of two blood bank units ; all of these patients who benefitted had estimated blood lost =1000 ml. (...)

    Mots-clés Pascal : Anévrysme, Aorte abdominale, Chirurgie, Peropératoire, Récupération, Sang, Analyse avantage coût, Economie santé, Transfusion, Traitement, Complication, Technique, Homme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie, Artère pathologie, Réanimation

    Mots-clés Pascal anglais : Aneurysm, Abdominal aorta, Surgery, Intraoperative, Recovery, Blood, Cost benefit analysis, Health economy, Transfusion, Treatment, Complication, Technique, Human, Cardiovascular disease, Vascular disease, Aortic disease, Arterial disease, Resuscitation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0417477

    Code Inist : 002B25F. Création : 10/04/1997.