Biomaterial Database

Cost-effectiveness of blood transfusion and white cell reduction in elective colorectal surgery. 1995

L S Jensen, and N Grunnet, and F Hanberg-Sørensen, and J Jørgensen

Department of Surgical Gastroenterology, Aarhus University Hospital, Denmark.

BACKGROUND The use of white cell (WBC)-reduced blood in elective colorectal surgery appears to reduce the frequency of postoperative infection. The question to be addressed is whether the cost:benefit ratio justifies the recommendation that WBC-reduced blood should be used for all colorectal surgery. METHODS Patients admitted for elective colorectal surgery (n = 197) were randomly assigned to receive transfusion consisting of whole blood or WBC-reduced whole blood. Postoperative complications, postoperative stay, and hospital charges were compared. RESULTS Forty-eight patients received WBC-reduced whole blood, 56 received unfiltered whole blood, and 93 received no transfusion. Postoperative infections were significantly higher (p < 0.001) in the group that received unfiltered whole blood. That group also had longer hospital stays: 17 days as compared to stays of 10 and 11 days for the group receiving no transfusion and the group receiving filtered whole blood transfusions, respectively (p < 0.01). The total hospital cost per patient receiving unfiltered whole blood was $12,347, as compared to $7,867 for those who received WBC-reduced whole blood and $7,030 for those who received no transfusion. CONCLUSIONS The use of WBC-reduced whole blood transfusions in elective colorectal surgery significantly reduces the frequency of postoperative infection, the length of hospital stay, and the total hospital charges for patients needing blood transfusion.

UI	MeSH Term	Description	Entries
D007937	Leukapheresis	The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor.	Leukocytapheresis,Leukopheresis,Lymphapheresis,Lymphocytapheresis,Leukocytopheresis,Lymphocytopheresis,Lymphopheresis,Leukaphereses,Leukocytaphereses,Leukocytophereses,Leukophereses,Lymphaphereses,Lymphocytaphereses,Lymphocytophereses,Lymphophereses
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D012002	Rectal Diseases	Pathological developments in the RECTUM region of the large intestine (INTESTINE, LARGE).	Anorectal Diseases,Anorectal Disorders,Rectal Disorders,Anorectal Disease,Anorectal Disorder,Rectal Disease,Rectal Disorder
D001803	Blood Transfusion	The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed)	Blood Transfusions,Transfusion, Blood,Transfusions, Blood
D003108	Colonic Diseases	Pathological processes in the COLON region of the large intestine (INTESTINE, LARGE).	Colonic Disease,Disease, Colonic,Diseases, Colonic
D003365	Costs and Cost Analysis	Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.	Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D005260	Female		Females