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

component-only resuscitation cost trauma whole blood

Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
09 Apr 2024
Historique:
medline: 9 4 2024
pubmed: 9 4 2024
entrez: 9 4 2024
Statut: aheadofprint

Résumé

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. 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. 576 patients were included (201 in WB and 375 in CORe). Whole blood conveyed a survival benefit vs CORe (OR 1.49 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.

Sections du résumé

BACKGROUND 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 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 RESULTS
576 patients were included (201 in WB and 375 in CORe). Whole blood conveyed a survival benefit vs CORe (OR 1.49
DISCUSSION CONCLUSIONS
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.

Identifiants

pubmed: 38591174
doi: 10.1177/00031348241241712
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

31348241241712

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Auteurs

Rachel C Murphy (RC)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Tyler W Johnson (TW)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Thomas J Mack (TJ)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Rachel E Burke (RE)

Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.

Nicholas P Damiano (NP)

Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.

Laura Heger (L)

Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.

Nicholas Minner (N)

Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.

Emily German (E)

Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.

Angela Wilson (A)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Michael G Mount (MG)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Brian C Thurston (BC)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Caleb J Mentzer (CJ)

Department of Surgery, Spartanburg Regional Healthcare System, Spartanburg, SC, USA.

Classifications MeSH