TY - JOUR
T1 - Efficacy and cost effectiveness of autologous blood predeposit in patients undergoing radical prostatectomy procedures
AU - Tim Goodnough, Lawrence
AU - Grishaber, Judy E.
AU - Birkmeyer, John D.
AU - Monk, Terri G.
AU - Catalona, William J.
PY - 1994/8
Y1 - 1994/8
N2 - Objectives: To assess the efficacy and cost-effectiveness of preoperative autologous blood donation (PAD) in radical prostatectomy procedures. Methods: A retrospective 3-year review was performed of transfusion outcomes in radicalprostatectomy procedures. Costs, benefits, and cost-effectiveness were established using a previously published Markov decision analysis model. Results: Three hundred eighty-four (97%) of 394 patients predonated 3.5 ± 0.6 (mean±SD) autologous blood units. Of these, 2.1 ± 1.2 units (60%) were retransfused. Forty-two (11 %) of 394 patients also received allogeneic blood. Autologous blood donors received only 0.2 ± 0.6 allogeneic blood units, compared with 1.4 ± 1.4 (p < 0.05) units transfused to patients who did not predonate. The net costs of PAD ranged from $83 to $303 per procedure. The life-expectancy benefit of PAD ranged from 0.05 to 0.07 days. The overall cost-effectiveness of PAD was estimated to be $1,813,000 per quality adjusted life-year saved. However, PAD was significantly more cost-effective for 2 unit donations ($531,000 per quality adjusted life-year saved). Conclusions: We conclude that autologous blood donation is an effective blood conservation strategy in elective radical prostatectomy. However, the cost-effectiveness of this practice compares unfavorably with that reported for other medical interventions. Alternative and more cost-effective strategies to reduce the need for allogeneic blood in this setting must be developed.
AB - Objectives: To assess the efficacy and cost-effectiveness of preoperative autologous blood donation (PAD) in radical prostatectomy procedures. Methods: A retrospective 3-year review was performed of transfusion outcomes in radicalprostatectomy procedures. Costs, benefits, and cost-effectiveness were established using a previously published Markov decision analysis model. Results: Three hundred eighty-four (97%) of 394 patients predonated 3.5 ± 0.6 (mean±SD) autologous blood units. Of these, 2.1 ± 1.2 units (60%) were retransfused. Forty-two (11 %) of 394 patients also received allogeneic blood. Autologous blood donors received only 0.2 ± 0.6 allogeneic blood units, compared with 1.4 ± 1.4 (p < 0.05) units transfused to patients who did not predonate. The net costs of PAD ranged from $83 to $303 per procedure. The life-expectancy benefit of PAD ranged from 0.05 to 0.07 days. The overall cost-effectiveness of PAD was estimated to be $1,813,000 per quality adjusted life-year saved. However, PAD was significantly more cost-effective for 2 unit donations ($531,000 per quality adjusted life-year saved). Conclusions: We conclude that autologous blood donation is an effective blood conservation strategy in elective radical prostatectomy. However, the cost-effectiveness of this practice compares unfavorably with that reported for other medical interventions. Alternative and more cost-effective strategies to reduce the need for allogeneic blood in this setting must be developed.
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U2 - 10.1016/S0090-4295(94)80136-3
DO - 10.1016/S0090-4295(94)80136-3
M3 - Article
C2 - 8048198
AN - SCOPUS:0028123011
SN - 0090-4295
VL - 44
SP - 226
EP - 231
JO - Urology
JF - Urology
IS - 2
ER -
