Cost effectiveness of blood substitution in elective orthopedic operations.
Cost effectiveness was compared between substitution with autologous blood, implying no risk of transmission of diseases, and homologous blood, with a definite risk of transmission. Primary and revision hip arthroplasties were included in this study, as well as scoliosis operations. The risk of contracting chronic non-A, non-B hepatitis (NANBH) was included in the calculations of the long-term economic consequences of a transmittable disease. Our study showed that predonated blood alone, with a donation of up to four units, was the most suitable and cost-effective method for substitution of blood losses up to about 2.5-3 liters A combination of predonated blood and intraoperative autotransfusion was more suitable and less expensive for substituting blood losses of 2.5 liters or more. Homologous blood was the least cost-effective alternative considering the influence of non-A, non-B hepatitis.
Elawad
A
A
Lund University Department of Orthopedics, Malmö General Hospital, Sweden.
Benoni
G
G
Montgomery
F
F
Hyddmark
U
U
Persson
U
U
Fredin
H
H
D000328:Adult; D001803:Blood Transfusion / Q000191:economics / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000191:economics; D003362:Cost-Benefit Analysis; D006526:Hepatitis C / Q000191:economics / Q000635:transmission; D006622:Hip Prosthesis; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D011300:Preoperative Care; D012086:Reoperation; D012307:Risk Factors; D012600:Scoliosis / Q000601:surgery