[Necessity for blood transfusion in head and neck surgery].
BACKGROUND
Sometimes, use of blood products is necessary in head and neck surgery, but blood transfusion also entails risks for the patients and causes high costs for the department. Therefore, we examined the surgical procedures in our department and analysed how often transfusion of blood was necessary and which expenses were incurred.


METHODS
Of 3989 operations performed in 1989, 187 patients were found to be at an increased risk for blood loss. The costs for blood group analysis (euro 23.16), cross-testing (euro 13.91) and the transfusion itself (euro 70.35) were estimated in each patient.


RESULTS
In 1998 more than 60% of the 187 patients had undergone extensive head and neck surgery for advanced squamous cell carcinoma. Only 17 patients (<15%) received nearly 45% of all units of stored blood transfused that year. In patients who had undergone skull base surgery, the probability of receiving blood was 30%. The transfusion-related costs were estimated to be euro 20,000 during the observation period. Potential savings could have been achieved in cross-testing.


CONCLUSIONS
Preparations should be done on an individual basis. Such preparations are sometimes unnecessary even in patients undergoing surgical procedures with a high risk for blood loss.
Jecker
P
P
Hals-Nasen-Ohrenklinik, Johannes-Gutenberg-Universität, Mainz. jecker@hno.klinik.uni-mainz.de
Melzer
A
A
Hitzler
W E
WE
D001788:Blood Grouping and Crossmatching / Q000191:economics; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000191:economics / Q000601:surgery*; D017046:Cost Savings; D017707:Erythrocyte Transfusion / Q000191:economics / Q000706:statistics & numerical data; D005151:Facial Injuries / Q000191:economics / Q000601:surgery; D005858:Germany; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs / Q000191:economics; D037981:Neck Dissection / Q000191:economics; D010039:Otorhinolaryngologic Neoplasms / Q000097:blood / Q000191:economics / Q000601:surgery*; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors
Vox Sang. 2000;78 Suppl 2:163-6
11203397
HNO. 2003 Jan;51(1):8-11
28271188
Lancet. 1993 Nov 27;342(8883):1328-33
7901637
South Med J. 1997 Dec;90(12):1217-24
9404909
HNO. 2004 Feb;52(2):137-9
14968316
HNO. 2004 Jul;52(7):604-10
15309257
Arch Otolaryngol Head Neck Surg. 1990 Mar;116(3):304-9
2306348
Arch Otolaryngol Head Neck Surg. 1994 Jul;120(7):707-10
8018321
Transfusion. 1993 Oct;33(10):794-7
8236418
Vox Sang. 1999;77(2):77-81
10516551
Can J Surg. 2001 Oct;44(5):355-8
11603748
N Engl J Med. 1993 May 13;328(19):1372-6
8292113
Laryngoscope. 1995 Aug;105(8 Pt 2 Suppl 73):1-17
7630307
Transfusion. 2001 Mar;41(3):333-7
11274586
Otolaryngol Head Neck Surg. 1992 Jan;106(1):60-7
1734370
Arch Pathol Lab Med. 1994 Apr;118(4):429-34
8166593
HNO. 1996 Sep;44(9):510-3
9005232
Laryngorhinootologie. 1994 Nov;73(11):561-7
7818739