Análisis de costo-efectividad del uso de salvador de células comparado con no uso en cirugías cardiovasculares en una ciudad intermedia en Colombia

Abstract

Introduction: Restrictive strategies are increasingly accepted in the decision to perform transfusions of blood products; cardiac surgery accounts for almost 20% of all surgical transfusions, cardiac surgeons has sought ways to minimize them with blood-saving techniques, such as the cell saver, which has enormous advantages and no absolute contraindication. In intermediate cities where there are no blood banks of their own or with regular response to the demand, its use is very important. It’s suggested that it may be more cost-effective to use the cell saver compared to the use of packaged red blood cells, which must be purchased in order to have them available on the day of surgery even if the transfusion is not performed.

Methodology: The present study aims to perform a cost-effective economic analysis comparing the use of the cell saver vs the use of packaged red blood cells in adult patients undergoing cardiac surgery in the city of Tunja (Boyacá, Colombia) during the year 2015.

Results: Incremental cost-effective analysis was performed. In addition, a lower rate of acute transfusion reactions was demonstrated with a better Hb level at the end of surgery, a lower number of packed red blood cells units transfused in the CS group, a significant difference p 0,05 in fresh frozen plasma transfusion which may suggest higher coagulopathy index in the control group.

Conclusions: The use of cell salvage is more cost-effective than the transfusion of packaged red blood cells to maintain or raise Hb levels at the end of surgery.