The use of blood cell salvage in acetabular fracture internal fixation surgery.
OBJECTIVE
To determine if the routine use of intraoperative blood cell salvage in acetabular fracture internal fixation reduces the need for allogenic blood transfusion, is cost effective, and whether it is influenced by the acetabular fracture pattern.


METHODS
A retrospective study.


METHODS
Tertiary pelvic and acetabular reconstructive center.


METHODS
Patients undergoing internal fixation for acetabular fractures.


RESULTS
Eighty consecutive patients were reviewed, comprising 26 elementary fracture (EF) and 54 associated fracture (AF) types. The mean volume of autologous blood transfused was 484 mL. The mean volume of 561 mL of autologous blood transfused in patients with AF types was significantly greater than the mean volume of 325 mL transfused in the EF group (P = 0.007). Additional allogenic blood transfusion was required in 5 (19%) patients with EFs and 15 (28%) patients with AFs (P = 0.418). The mean cost of the blood cell salvage and additional blood products in our study was $223 (£135) for all fracture types ($174/£105 for EF and $246/£149 for AF).When treating AF types, the mean cost of using blood cell salvage was $246 (£149) as compared with the mean predicted cost of not using blood cell salvage and transfusing the equivalent of 1.7 units of allogenic blood instead, which was $463 (£281). These distributions are significantly different (P = 0.01).


CONCLUSIONS
The use of blood cell salvage for internal fixation surgery for acetabular fracture is cost effective, particularly when treating AF types, and its routine use is advocated to limit the need for allogenic blood transfusion.
Pelvic and Acetabular Reconstruction Unit, Frenchay Hospital, Frenchay, Bristol, United Kingdom.
Ewan
E
Bigsby
Mehool R
MR
Acharya
Anthony J
AJ
Ward
Timothy Js
TJ
Chesser
D000077:Acetabulum / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000191:economics* / Q000379:methods; D050723:Fractures, Bone / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007430:Intraoperative Care / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000191:economics* / Q000706:statistics & numerical data; D059351:Organ Sparing Treatments; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult