Niels Grunnet, MD, DMSci, Chief Consultant, Department of Clinical Immunology, Aarhus University Hospital.
Cost-effectiveness of blood transfusion and white cell reduction in elective colorectal surgery
Article first published online: 28 FEB 2003
Volume 35, Issue 9, pages 719–722, September 1995
How to Cite
Jensen, L.S., Grunnet, N., Hanberg-Sorensen, F. and Jorgensen, J. (1995), Cost-effectiveness of blood transfusion and white cell reduction in elective colorectal surgery. Transfusion, 35: 719–722. doi: 10.1046/j.1537-2995.1995.35996029153.x
- Issue published online: 28 FEB 2003
- Article first published online: 28 FEB 2003
- Received for publication February 20, 1995; revision received May 26, 1995; and accepted May 29, 1995.
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.
STUDY DESIGN AND 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.
CONCLUSION: 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.