title: Leukocyte-reduced transfusions in cardiac surgery results of an implementation trial.
abstract: An implementation trial of leukocyte-reduced transfusions in cardiac surgery (primary coronary artery bypass graft and valve replacement) was performed from July to December 1998; comparisons were made with data from the same period in 1997. Patients from both periods were similar in important preoperative and intraoperative variables (age, sex, weight, number of units of RBCs transfused, ejection fraction). The mean total number of complications was statistically significantly decreasedfrom 0.26 complications per patient in the non-leukocyte-reduced to 0.19 in the leukocyte-reduced recipients. Overall, the mean +/- ISD costs of care per patient decreasedfrom 1997 ($27,615 +/- $33,973) to 1998 ($27,038 +/- $24,107). Mean costs decreased $1,700 per patient for recipients of leukocyte-reduced blood in 1998 compared with recipients of non-leukocyte-reduced blood in 1997 Mean costs increased $4,000 per patient in patients who did not receive transfusions in 1998 compared with 1997. Hospitalization costs decreased when leukocyte-reduced transfusions were implemented for patients undergoing cardiac surgery in our institution. Implementation of leukocyte reduction may be cost neutral or cost saving in at least some settings.
authors.affiliation: Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, NY 14642, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Blumberg
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Heal
authors.forename: Judith W
authors.initials: JW
authors.lastname: Cowles
authors.forename: George L
authors.initials: GL
authors.lastname: Hicks
authors.forename: William H
authors.initials: WH
authors.lastname: Risher
authors.forename: Prem K
authors.initials: PK
authors.lastname: Samuel
authors.forename: Scott A
authors.initials: SA
authors.lastname: Kirkley
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000502:physiology; D000368:Aged; D001803:Blood Transfusion / Q000191:economics / Q000379:methods*; D001026:Coronary Artery Bypass / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D006284:Health Plan Implementation / Q000191:economics*; D019918:Heart Valve Prosthesis Implantation / Q000191:economics*; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000191:economics; D007962:Leukocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control; D065227:Transfusion Reaction
chemical_list: D000276:Adjuvants, Immunologic