title: Removal of erythropoietin from anaemia trauma practice guideline does not increase red blood cell transfusions and decreases hospital utilization costs.
abstract: BACKGROUND
  We previously demonstrated that utilization of erythropoietin (r-EPO) did not significantly reduce blood utilization in trauma patients. We undertook this study to analyze blood utilization 1 year after r-EPO removal from our trauma service anaemia practice management guideline.
  
  
  METHODS
  Electronic records of patients admitted to the trauma service were retrospectively reviewed for units of packed red blood cells (pRBCs) transfused and for units of r-EPO administered 12 months before the initiation of an anaemia practice guideline (PRE), 12 months during the use of an anaemia guideline (GUIDE), and 12 months following removal of r-EPO from the guideline (POST). Hospital acquisition cost was also reviewed for the respective time periods. Nominal data were analyzed using chi-squared or Fisher's exact tests, and interval data were compared using ANOVA followed by Tukey's test where appropriate. Results were considered significant for P<0.05.
  
  
  RESULTS
  Over the 3-year study period, 4881 patients were admitted to the trauma service and included in this study. The hospital length of stay, intensive care unit length of stay, and units of pRBC transfused were similar among all three groups. Group I (PRE) received a total of 228 doses of r-EPO at a cost of $102,600. Group II (GUIDE) received a total of 410 doses at a cost of $184,500. Group III (POST) received 28 doses of r-EPO at a cost of $12,600.
  
  
  CONCLUSIONS
  Removal of erythropoietin from our trauma service anaemia practice management guideline did not result in increased blood utilization. However, it yielded a hospital acquisition cost savings of $171,900.
authors: The F.H. Sammy Ross, Jr. Trauma Center, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. ashley.christmas@carolinashealthcare.org
authors: A Britton
authors: AB
authors: Christmas
authors: Steven M
authors: SM
authors: Camp
authors: M Craig
authors: MC
authors: Barrett
authors: Thomas M
authors: TM
authors: Schmelzer
authors: H James
authors: HJ
authors: Norton
authors: Toan T
authors: TT
authors: Huynh
authors: Michael H
authors: MH
authors: Thomason
authors: Ronald F
authors: RF
authors: Sing
mesh_terms: D000208:Acute Disease; D000328:Adult; D000704:Analysis of Variance; D000740:Anemia / Q000191:economics / Q000209:etiology / Q000628:therapy*; D017046:Cost Savings; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data; D057286:Electronic Health Records; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D004921:Erythropoietin / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011994:Recombinant Proteins; D012189:Retrospective Studies; D014193:Trauma Centers / Q000191:economics; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin