Marco Scardino1, Federica Martorelli1, Tiziana D'Amato1, Giorgia Fenocchio1, Vincenzo Simili1, Guido Grappiolo2, Berardo Di Matteo3,4, Elizaveta Kon5,6, Michele Lagioia6. 1. Anesthesiology Hip and Knee Replacement Unit, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. 2. Hip Diseases and Joint Replacement Surgery Unit, Humanitas Clinical and Research Center, Via Alessandro Manzoni 56, Rozzano, 20089, Milan, Italy. 3. Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano, 20089, Milan, Italy. berardo.dimatteo@gmail.com. 4. Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, 20089, Milan, Italy. berardo.dimatteo@gmail.com. 5. Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano, 20089, Milan, Italy. 6. Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
Abstract
PURPOSE: Blood transfusion and blood management are important aspects in orthopaedic surgery. Strategies include intra-operative and post-operative blood salvage and even the use of fibrin sealant in selected case. Objectives of the study were (1) to compare the total number of transfusions and the length of hospital stay in patients undergoing complete revision hip arthroplasty (RHA) with and without the use of a fibrin sealant (EVICEL®) and (2) to evaluate the possible role in cost savings of EVICEL® in association with the blood-saving protocol. METHODS: Retrospective observational study evaluating patients undergoing complete RHA (stem + cup) with a blood-saving protocol with (n = 50) and without EVICEL® (n = 60). The outcome measures were: number of patients transfused (allogeneic red blood cells-RBC-and plasma), amount of blood/plasma transfusions, quantity of re-infused recycled blood, and length of hospital stay. An economic model was developed to assess the differences in costs between the two groups. RESULTS: EVICEL® reduced the number of transfused red blood cells and plasma (p < 0.001), and the hospital stay (p = 0.01) compared to control group. EVICEL® can induce a reduction in resource consumption with an average cost-savings of €1.676 per patient. CONCLUSION: EVICEL® may be effective in reducing red blood cells and plasma transfusion as well as hospital stay. The inclusion of EVICEL® in a blood-saving protocol seems to produce clinical efficacy and cost savings.
PURPOSE: Blood transfusion and blood management are important aspects in orthopaedic surgery. Strategies include intra-operative and post-operative blood salvage and even the use of fibrin sealant in selected case. Objectives of the study were (1) to compare the total number of transfusions and the length of hospital stay in patients undergoing complete revision hip arthroplasty (RHA) with and without the use of a fibrin sealant (EVICEL®) and (2) to evaluate the possible role in cost savings of EVICEL® in association with the blood-saving protocol. METHODS: Retrospective observational study evaluating patients undergoing complete RHA (stem + cup) with a blood-saving protocol with (n = 50) and without EVICEL® (n = 60). The outcome measures were: number of patients transfused (allogeneic red blood cells-RBC-and plasma), amount of blood/plasma transfusions, quantity of re-infused recycled blood, and length of hospital stay. An economic model was developed to assess the differences in costs between the two groups. RESULTS:EVICEL® reduced the number of transfused red blood cells and plasma (p < 0.001), and the hospital stay (p = 0.01) compared to control group. EVICEL® can induce a reduction in resource consumption with an average cost-savings of €1.676 per patient. CONCLUSION:EVICEL® may be effective in reducing red blood cells and plasma transfusion as well as hospital stay. The inclusion of EVICEL® in a blood-saving protocol seems to produce clinical efficacy and cost savings.
Entities:
Keywords:
Blood management; Evicel; Fibrin sealant; Revision; Total hip arthroplasty; Transfusion
Authors: Khaled M Musallam; Hani M Tamim; Toby Richards; Donat R Spahn; Frits R Rosendaal; Aida Habbal; Mohammad Khreiss; Fadi S Dahdaleh; Kaivan Khavandi; Pierre M Sfeir; Assaad Soweid; Jamal J Hoballah; Ali T Taher; Faek R Jamali Journal: Lancet Date: 2011-10-05 Impact factor: 79.321
Authors: Berardo Di Matteo; Alberto Polignano; Francesco Onorato; Agostino La Porta; Francesco Iacono; Tommaso Bonanzinga; Giovanni Raspugli; Maurilio Marcacci; Elizaveta Kon Journal: Cartilage Date: 2020-09-22 Impact factor: 3.117