Intraoperative hemodilution is more cost-effective than preoperative autologous donation for patients undergoing procedures associated with a low risk for transfusion

Meg A. Rosenblatt, Ernesto M. Cantos, Kala Mohandas

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Study Objective: To determine the utilization and cost of autologous blood that was donated preoperatively, and to 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: University 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 autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6% savings. Conclusions: Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.

Original languageEnglish (US)
Pages (from-to)26-29
Number of pages4
JournalJournal of Clinical Anesthesia
Volume9
Issue number1
DOIs
StatePublished - Feb 1997
Externally publishedYes

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Hemodilution
Costs and Cost Analysis
Blood Banks
Cost Savings
Blood Donors
Blood Transfusion
Patient Selection

Keywords

  • autologous predonation
  • Hemodilution

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Intraoperative hemodilution is more cost-effective than preoperative autologous donation for patients undergoing procedures associated with a low risk for transfusion",
abstract = "Study Objective: To determine the utilization and cost of autologous blood that was donated preoperatively, and to 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: University 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 autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6{\%} savings. Conclusions: Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.",
keywords = "autologous predonation, Hemodilution",
author = "Rosenblatt, {Meg A.} and Cantos, {Ernesto M.} and Kala Mohandas",
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AU - Cantos, Ernesto M.

AU - Mohandas, Kala

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N2 - Study Objective: To determine the utilization and cost of autologous blood that was donated preoperatively, and to 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: University 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 autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6% savings. Conclusions: Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.

AB - Study Objective: To determine the utilization and cost of autologous blood that was donated preoperatively, and to 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: University 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 autologous blood was determined. The cost for employing intraoperative hemodilution and potential cost saving was then calculated. Of the 234 units of preoperatively donated autologous blood, 38 units were returned to patients who had an estimated blood loss of at least 500 ml, 32 units returned to patients who had an estimated blood loss less than 500 ml, and 164 units were wasted. No patient received allogeneic blood. The estimated total cost for all preoperatively donated autologous blood was $23,274.62. Employing hemodilution for those same patients would have cost $5,574.74, and resulted in a potential 75.6% savings. Conclusions: Inappropriate selection of patients for preoperative blood donation is costly. For those patients scheduled to undergo surgical procedures associated with a low probability for the need for blood transfusion, but who desire that autologous blood be available, hemodilution provides fresh whole blood, free from the possibility of processing or clerical errors, while decreasing blood bank utilization and affording substantial cost savings.

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