Economic evaluation of a randomized clinical trial of haemodilution with cell salvage in aortic surgery

Haynes, Sarah L.; Torella, Francesco; Wong, John; Dalrymple, K; James, Marilyn; McCollum, Charles

doi:10.1046/j.1365-2168.2002.02086.x

Cited by 18 publications

(23 citation statements)

References 22 publications

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“…Although the cost-benefit ratio of ICS in this study was not directly assessed, economic analysis of ICS has been undertaken by other groups who found that even in centres with low levels of surgical activity, ICS is cost neutral [16,17].…”

Section: Discussionmentioning

confidence: 99%

Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage

et al. 2007

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“…The value of this combination has been evaluated in a randomized controlled trial, confirming a significant reduction in allogeneic blood requirements [44]. This transfusion strategy combining ANH and ICS for AAA surgery was also cost-effective [41].…”

Section: Autologous Transfusionmentioning

confidence: 99%

“…Oxygen delivery following allogeneic blood is also impaired by loss of 2,3-diphosphoglycerate (2,3-DPG). Such effects may enhance the susceptibility to peri-operative infection in the elderly and worsen the outcome in aortic surgery [40,41]. More recently, the discovery of variant Creutzfeldt-Jakob disease prompted changes in the management of blood products, including the ban of British plasma from fractionation and routine leucodepletion of red cells.…”

Section: Blood Transfusion Strategiesmentioning

confidence: 99%

Screening, Diagnosis and Advances in Aortic Aneurysm Surgery

Daly¹,

Torella²,

Ashleigh

et al. 2004

Gerontology

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Background: Aortic aneurysms are common in the elderly and a frequent cause of sudden death. As elective aneurysm repair has a mortality drastically lower than that associated with rupture, the emphasis must be on early detection and repair free from complications. Recent advances include ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA) and clinical trials on the size of AAA that require repair. Pre-operative assessment, management of cardiac risk, autologous blood transfusion strategies, and endovascular stent graft technology to avoid major open surgery are all issues to be addressed. Methods: Following a computerized Medline search for publications on the detection and treatment of abdominal and thoracic aortic aneurysm, the publications identified were then read and the references within those publications examined for further publications on this topic. We have reviewed these publications without attempting a meta-analysis. Results: Randomized population studies have addressed ultrasound screening for AAA. Attendance for screening was good and AAA detection inexpensive. Screening men from 65 years reduces the mortality from rupture and is cost-effective. Open thoracic and abdominal aneurysm repair has a mortality of around 8%, with myocardial infarction being a frequent cause of death. Pre-operative reduction of cardiac risk by cardiac investigations and β-blockade may reduce this mortality. Autologous transfusion techniques such as acute normovolaemic haemodilution and interoperative cell salvage reduce the need for allogeneic blood and the complications associated with open surgery. Minimally invasive endovascular repair is now possible for 40% of the AAA and an increasing proportion of thoracic aneurysms. Conclusions: The combination of screening, reduced pre-operative risk, and new minimally invasive techniques extends aortic aneurysm treatment into an increasingly elderly population. The combination of these techniques will reduce mortality from ruptured aortic aneurysm in the elderly and also reduce the stress associated with aneurysm surgery.

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“…Not surprisingly, operator error can lead to significant problems, 14 thus underlining the need for appropriate training and standardized operating procedures. Haynes and colleagues 12 found that even when apparently different initial outlay or running costs were analyzed in annual or true cost per case basis, the calculated costs of three suppliers became very similar. They looked at initial capital costs, maintenance and cost of consumables.…”

mentioning

confidence: 99%

“…12 This study was actually in the context of aortic surgery so may not be strictly comparable to cardiac surgery, however the methodology could be applied to the cardiac context. Taking all factors into account, including capital and revenue, running costs and impact on procedure time compared to allogeneic RBCs the study found very little cost difference between CS and allogeneic transfusions.…”

mentioning

confidence: 99%

Cell Salvage in Cardiothoracic Surgery: Cost Issues

Morgan

Cooper

2003

Transfus Alt Transfus Med

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Economic evaluation of a randomized clinical trial of haemodilution with cell salvage in aortic surgery

Abstract: Autologous transfusion is cost neutral in aortic surgery even when surgical activity is low.

Cited by 18 publications

References 22 publications

Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage

Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage

Screening, Diagnosis and Advances in Aortic Aneurysm Surgery

Cell Salvage in Cardiothoracic Surgery: Cost Issues

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