Platelet-rich plasmapheresis: a meta-analysis of clinical outcomes and costs.
Platelet-rich plasmapheresis (PRP) just prior to cardiopulmonary bypass (CPB) surgery is used to improve post CPB hemostasis and to minimize the risks associated with exposure to allogeneic blood and its components. Meta-analysis examines evidence of PRP's impact on clinical outcomes by integrating the results across published research studies. Data on clinical outcomes was collected from 20 published studies. These outcomes, DRG payment rates, and current national average costs were used to examine the impact of PRP on costs. This study provides evidence that the use of PRP results in improved clinical outcomes when compared to the identical control groups not receiving PRP. These improved clinical outcomes result in subsequent lower costs per patient in the PRP groups. All clinical outcomes analyzed were improved: blood product usage, length of stay, intensive care stay, time to extubation, incidence of cardiovascular accident, and incidence of reoperation. The most striking differences occur in use of all blood products, particularly packed red blood cells. This study provides an example of how initial expenditure on technology used during CPB results in overall cost savings. Estimated cost savings range from $2,505.00 to $4,209.00. More importantly, patients benefit from improved clinical outcomes.
Mahoney
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CB
Industrial Relations Center, University of Minnesota, Minneapolis 55455-0430, USA.
D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods; D002315:Cardiopulmonary Bypass; D017046:Cost Savings; D003365:Costs and Cost Analysis; D003422:Critical Care; D003953:Diagnosis-Related Groups / Q000191:economics; D017707:Erythrocyte Transfusion; D006488:Hemostasis, Surgical; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal; D007902:Length of Stay; D013677:Medical Laboratory Science / Q000191:economics; D009203:Myocardial Infarction / Q000517:prevention & control; D010956:Plasmapheresis / Q000191:economics / Q000379:methods*; D017713:Platelet Transfusion / Q000191:economics / Q000379:methods; D012086:Reoperation; D012307:Risk Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome