Blood utilization in hip and knee arthroplasty: a cost-minimization study

Area of Science:

• Transfusion Medicine
• Surgical Patient Blood Management
• Health Economics

Background:

• Non-utilization of crossmatched blood represents a significant and costly waste of resources in healthcare settings.
• Optimizing blood ordering practices is crucial for improving efficiency and reducing healthcare expenditures.

Purpose of the Study:

• To evaluate the impact of a group, screen, and save (G & S) only policy versus routine pre-operative crossmatching on blood utilization in total hip and knee arthroplasty.
• To assess the safety, practicality, and cost-effectiveness of the G & S policy.

Main Methods:

• A comparative audit of blood utilization was conducted for primary total hip and knee arthroplasty patients across two phases.
• Phase 1 involved routine pre-operative crossmatching, while Phase 2 implemented a group, screen, and save (G & S) only policy.
• Patient demographics, pre- and post-operative hemoglobin levels, and transfusion outcomes were analyzed.

Main Results:

• In Phase 1, 60% (127/213) of crossmatched blood units were transfused, compared to 100% (117/117) in Phase 2.
• No significant differences in pre- and post-operative hemoglobin levels were observed between the two phases.
• No adverse transfusion reactions were reported in either phase.

Conclusions:

• A group, screen, and save (G & S) only policy is a safe and practical alternative to routine pre-operative crossmatching for hip and knee arthroplasty.
• This policy enhances the efficiency and cost-effectiveness of blood ordering, with estimated annual savings exceeding 8000 Pounds.
• The findings support the adoption of G & S policies to minimize blood waste and optimize resource allocation in surgical settings.