Utility and cost of low-vacuum reinfusion drains in patients undergoing surgery for subcapital hip fracture repair. A before and after cohort study
Article first published online: 22 JUL 2013
© 2013 International Society of Blood Transfusion
Volume 106, Issue 1, pages 83–91, January 2014
How to Cite
Muñoz, M., Iglesias, D., Garcia-Erce, J. A., Cuenca, J., Herrera, A., Martin-Montañez, E. and Pavia, J. (2014), Utility and cost of low-vacuum reinfusion drains in patients undergoing surgery for subcapital hip fracture repair. A before and after cohort study. Vox Sanguinis, 106: 83–91. doi: 10.1111/vox.12071
- Issue published online: 17 DEC 2013
- Article first published online: 22 JUL 2013
- Manuscript Accepted: 24 JUN 2013
- Manuscript Revised: 18 JUN 2013
- Manuscript Received: 14 MAY 2013
- Instituto Aragonés de Ciencias de la Salud (Zaragoza, Spain). Grant Number: ICS 08/0208
- allogeneic transfusion;
- IV iron;
- low-vacuum reinfusion drain;
- recombinant human erythropoietin;
- subcapital hip fracture;
- transfusion protocol
Postoperative blood loss may be a risk factor for allogeneic blood transfusion (ABT) in patients undergoing subcapital hip fracture (SHF) repair. We investigated the utility and costs of using a low-vacuum reinfusion drain (Bellovac ABT) within a blood management protocol for reducing ABT requirements in consecutive SHF.
The blood management protocol consisted of the application of a restrictive transfusion trigger (Hb < 8 g/dl), the peri-operative administration of IV iron sucrose (3 × 200 mg/48 h) ± recombinant erythropoietin (1 × 40 000 IU sc) and the use of Bellovac ABT (Group 2, n = 117). An immediate previous SHF series managed without Bellovac ABT served as control (Group 1, n = 138).
Overall, 72 out of 255 (28%) received at least one ABT unit (2·1 ± 1·0 U/transfused patient) without differences between groups. However, in the subgroup of patients with admission Hb < 13 g/dl, the use of Bellovac ABT reduced postoperative ABT rates (16% vs. 46%, for groups 2 and 1, respectively; P = 0·001), although only 3 were reinfused, and was cost-saving. The use of Bellovac ABT also resulted in fewer wound bleeding complications, but there were no differences in Hb at postoperative days 7 and 30 between groups.
In SHF patients with admission Hb < 13 g/dl and managed with peri-operative IV iron ± recombinant erythropoietin plus restrictive transfusion indication, the use of Bellovac ABT was associated with reduced ABT requirements, without increasing postoperative complications, and cost-savings.