title: [Necessity for blood transfusion in head and neck surgery].
abstract: 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.
authors.affiliation: Hals-Nasen-Ohrenklinik, Johannes-Gutenberg-Universität, Mainz. jecker@hno.klinik.uni-mainz.de
authors.forename: P
authors.initials: P
authors.lastname: Jecker
authors.forename: A
authors.initials: A
authors.lastname: Melzer
authors.forename: W E
authors.initials: WE
authors.lastname: Hitzler
mesh_terms: 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
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