Previous analyses have found autologous transfusion to be very expensive but have not considered avoidance of postoperative bacterial infections as one of its benefits.
A cost-utility analysis using a Markov cohort simulation model compared autologous blood transfusion to allogeneic transfusion in a hypothetical cohort of patients undergoing elective total hip replacement with respect to discounted quality-adjusted life years (QALYs) and health-care system costs.
Assuming a base case rate of serious infection of 3.7 percent, a relative risk of infection of 1.85, and additional costs of $12,980 per infection, autologous transfusion has a cost-effectiveness of $2,470 per QALY.
If the relative risk of bacterial infection following allogeneic transfusion exceeds 1.1, the cost-effectiveness of autologous transfusion is less than $50,000 per QALY and if the relative risk exceeds 2.4, autologous transfusion is dominant, resulting in both lower costs and greater QALYs.
If there were no increased risk of transfusion, the cost-effectiveness of autologous transfusion would be $3,400,000 per QALY.
If there is only a modest increase in the risk of bacterial infection following allogeneic transfu sion, autologous transfusion would result in improved outcomes at a cost of less than $50,000 per QALY. (...)
Mots-clés Pascal : Transfusion, Sang, Système autologue, Analyse coût efficacité, Système allogénique, Bactériose, Infection, Complication, Iatrogène, Risque élevé, Economie santé, Homme
Mots-clés Pascal anglais : Transfusion, Blood, Autologous system, Cost efficiency analysis, Allogeneic system, Bacteriosis, Infection, Complication, Iatrogenic, High risk, Health economy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0460441
Code Inist : 002B27D01. Création : 22/03/2000.