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Utility and cost of low‐vacuum reinfusion drains in patients undergoing surgery for subcapital hip fracture repair. A before and after cohort study
Author(s) -
Muñoz M.,
Iglesias D.,
GarciaErce J. A.,
Cuenca J.,
Herrera A.,
MartinMontañez E.,
Pavia J.
Publication year - 2014
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.12071
Subject(s) - medicine , blood transfusion , surgery , erythropoietin , hip fracture , cohort , anemia , blood loss , anesthesia , iron sucrose , blood management , intravenous iron , iron deficiency , osteoporosis
Background Postoperative blood loss may be a risk factor for allogeneic blood transfusion ( ABT ) in patients undergoing subcapital hip fracture ( SHF ) repair. We investigated the utility and costs of using a low‐vacuum reinfusion drain (Bellovac ABT ) within a blood management protocol for reducing ABT requirements in consecutive SHF . Methods The blood management protocol consisted of the application of a restrictive transfusion trigger (Hb < 8 g/dl), the peri‐operative administration of IV iron sucrose (3 × 200 mg/48 h) ± recombinant erythropoietin (1 × 40 000 IU sc) and the use of Bellovac ABT (Group 2, n = 117). An immediate previous SHF series managed without Bellovac ABT served as control (Group 1, n = 138). Results Overall, 72 out of 255 (28%) received at least one ABT unit (2·1 ± 1·0 U/transfused patient) without differences between groups. However, in the subgroup of patients with admission Hb < 13 g/dl, the use of Bellovac ABT reduced postoperative ABT rates (16% vs. 46%, for groups 2 and 1, respectively; P = 0·001), although only 3 were reinfused, and was cost‐saving. The use of Bellovac ABT also resulted in fewer wound bleeding complications, but there were no differences in Hb at postoperative days 7 and 30 between groups. Conclusions In SHF patients with admission Hb < 13 g/dl and managed with peri‐operative IV iron ± recombinant erythropoietin plus restrictive transfusion indication, the use of Bellovac ABT was associated with reduced ABT requirements, without increasing postoperative complications, and cost‐savings.