Artikel
Efficacy and cost effectiveness of intraoperative blood salvage in cerebral aneurysm clipping
Effektivität und Kostenanalyse des Cell-saver Einsatzes in der chirurgischen Behandlung zerebraler Aneurysmen
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Veröffentlicht: | 26. Juni 2020 |
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Gliederung
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Objective: The use and effectiveness of intraoperative cell salvage has been introduced in many surgical specialties. Until now no data exists evaluating the efficacy of intraoperative cell salvage in cerebral aneurysm surgery.
Aim of the present study is to evaluate the efficacy and cost effectiveness of intraoperative cell salvage in cerebral aneurysm surgery.
Methods: Data were collected retrospectively for all the patients who underwent cerebral aneurysm surgery at our institution. All cases were divided in ruptured cerebral aneurysm group and unruptured cerebral aneurysm group.
Results: A total of 212 patients underwent cerebral aneurysm clipping. 102 treated aneurysms were ruptured and 110 were unruptured and clipped electively. The mean preoperative hemoglobin levels of both groups were 13.7 g/dl and 12.8 g/dl respectively, p = 0.9. The mean intraoperative blood loss was 204.5 ml and 633 ml, p = 0.0001. Retransfusion of salvaged blood could only be facilitate in 2 cases with ruptured cerebral aneurysms and in none being clipped electively. Of the 212 patients, 31 patients with ruptured cerebral aneurysms and one patient with unruptured cerebral aneurysm required transfusion after surgery and 64 vs. 2 units of blood were transfused, p = 0.001. The mean postoperative hemoglobin levels were 11.5 g/dl and 10.7 g/dl respectively, p = 0.03.
In terms of cost effectiveness, a total of 42,400 € in 2012 patients were spend to run the cell saver. Additional 26,400 € were spent for allogenic blood transfusion.
Conclusion: The use of cell salvage in cerebral aneurysm clipping is neither efficient nor cost effective.