Cost Savings of Whole Blood Versus Component Therapy at a Community Level 1 Trauma Center.

Autor:	Murphy RC; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Johnson TW; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Mack TJ; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Burke RE; Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA., Damiano NP; Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA., Heger L; Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA., Minner N; Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA., German E; Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA., Wilson A; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Mount MG; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Thurston BC; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA., Mentzer CJ; Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Sep; Vol. 90 (9), pp. 2156-2159. Date of Electronic Publication: 2024 Apr 09.
DOI:	10.1177/00031348241241712
Abstrakt:	Background: Blood product component-only resuscitation (CORe) has been the standard of practice in both military and civilian trauma care with a 1:1:1 ratio used in attempt to recreate whole blood (WB) until recent data demonstrated WB to confer a survival advantage, leading to the emergence of WB as the contemporary resuscitation strategy of choice. Little is known about the cost and waste reduction associated with WB vs CORe. Methods: This study is a retrospective single-center review of adult trauma patients admitted to a community trauma center who received WB or CORe as part of their massive transfusion protocol (MTP) resuscitation from 2017 to 2021. The WB group received a minimum of one unit WB while CORe received no WB. Univariate and multivariate analyses were completed. Statistical analysis was conducted using a 95% confidence level. Non-normally distributed, continuous data were analyzed using the Wilcoxon rank sum test. Results: 576 patients were included (201 in WB and 375 in CORe). Whole blood conveyed a survival benefit vs CORe (OR 1.49 P < .05, 1.02-2.17). Whole blood use resulted in an overall reduction in products prepared (25.8%), volumes transfused (16.5%), product waste (38.7%), and MTP activation (56.3%). Cost savings were $849 923 annually and $3 399 693 over the study period. Discussion: Despite increased patient volumes over the study period (43.7%), the utilization of WB as compared to CORe resulted in an overall $3.39 million cost savings while improving mortality. As such, we propose WB should be utilized in all resuscitation strategies for the exsanguinating trauma patient. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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