Cost-effectiveness of preoperative autologous blood donation for orthopedic and cardiac surgeries.

Decision analysis techniques can be used to determine objectively the health improvement benefit obtained from a medical intervention relative to the resources required for the intervention. Such calculations can help direct societal healthcare policies but may not be directly applicable to an individual patient. However, these analyses can still be used to indicate those situations in which an intervention is most beneficial and those in which its use may not be appropriate. Preoperative autologous blood donation (PABD), for example, may not be cost-effective if blood units are collected when they are not likely to be used or if such units are transfused solely because they are available. Furthermore, the risks associated with PABD may exceed those of the allogeneic transfusion that the patient seeks to avoid, particularly in patients with significant cardiac disease. In such settings, careful, objective analyses may help direct not only healthcare policy but also hemotherapy practice for individual patients.