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

The non-utilization of crossmatched blood is an expensive waste of resources. We have audited blood utilization for all primary total hip and knee arthroplasty patients. We compared routine pre-operative crossmatching (Phase 1) with a policy of group, screen and save (G & S) only (Phase 2). The patient groups were similar in both phases. Pre- and post-operative haemoglobin results were not significantly different between Phase 1 and 2. No adverse transfusion reactions occurred. In Phase 1, 213 units were crossmatched pre-operatively, but only 127 (60%) were transfused. In Phase 2, 117 units were requested and all transfused. The G & S only policy proved to be a safe and practical option which improved the efficiency and cost-effectiveness of blood ordering. Based on a handling charge of 37.50 Pounds per unit of blood by the Regional Transfusion Centre, an estimated annual saving of over 8000 Pounds can be made in our directorate.