Blood filters result in $3,000-$6,000 savings
Blood filters result in $3,000-$6,000 savings
Bypass heart-lung, reduce open-heart LOS costs
A new study of open-heart surgery patients found that filtering leukocytes reduces the risks associated with the surgery, improves outcomes, and significantly decreases length of stay (LOS) and costs.1 "One of the greatest problems with open-heart surgery is inflammatory injury," wrote John Parker Gott, MD, chief of cardiac surgery at Atlanta’s Crawford Long Hospital, and the study’s lead investigator. Inflammatory injury occurs when the patient’s own blood is returned to the patient after circulating through the cardiopulmonary bypass (CPB) circuit. The response causes cell damage and diminished organ function leading to increased morbidity and a longer recovery time with an increase in both LOS and costs.
Examining 400 open-heart patients, investigators found a significant decrease (20%) in LOS (5.4 versus 6.8 days) and a significant decrease in mean charges ($33,000 versus $39,000) for a majority of patients when leukocyte reduction filters were used. The study compared the current standard of practice plus aprotinin; the standard plus leukocyte filtration; and the standard with internal surfaces of components of the heart-lung machine coated with heparin. The patients who received the greatest benefit from leukocyte filtration were those at low risk. For patients stratified as high risk, the aprotinin treatment had a significant LOS reduction (7.4 vs. 8.2 days), and a significant mean reduction in charges ($49,000 vs. $55,000). No significant effects for any of the three procedures were found in the medium risk group.
"The study’s findings have demonstrated that we can make open-heart surgery even safer and save money at the same time," wrote Gott.
Crawford Long has incorporated leukocyte filtration of all transfused blood products for all open-heart surgery patients across all risk strata. The institution also filters of patients’ blood stratified as low risk — the majority of open-heart patients.
Reference
1. Gott JP, Cooper WA, Schmidt FE, et al. Modifying risk for extracorporeal circulation: Trial of four anti-inflammatory strategies. Ann Thor Sur 1998; 66(3):747.
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