Removal of erythropoietin from anaemia trauma practice guideline does not increase red blood cell transfusions and decreases hospital utilization costs.
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.
Christmas
A Britton
AB
The F.H. Sammy Ross, Jr. Trauma Center, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA. ashley.christmas@carolinashealthcare.org
Camp
Steven M
SM
Barrett
M Craig
MC
Schmelzer
Thomas M
TM
Norton
H James
HJ
Huynh
Toan T
TT
Thomason
Michael H
MH
Sing
Ronald F
RF
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*
D011994:Recombinant Proteins; D004921:Erythropoietin