%0 Journal Article
%A Leon-Justel, Antonio
%A Alvarez-Rios Ana I
%A Noval-Padillo, Miguel A
%A Gómez-Bravo, Miguel Ángel
%A Porras, Manuel
%A Gomez-Sosa, Laura
%A Lopez-Romero, Juan L
%A Guerrero, Juan M
%T Point-of-care haemostasis monitoring during liver transplantation is cost effective
%D 2019
%@ 1437-4331
%U https://hdl.handle.net/10668/23211
%X Background: Optimal haemostasis management in orthotropic liver transplant (OLT) could reduce blood loss and transfusion volume, improve patient outcomes and reduce cost.Methods: We performed a study including 336 OLTs to evaluate the clinical and cost effectiveness of a new pointof- care (POC)-based haemostatic management approach in OLT patients.Results: In terms of health benefit we found that the new approach showed a significant reduction in transfusion requirements (red blood cell transfusion units were reduced from 5.3 ± 4.6 to 2.8 ± 2.9 [p < 0.001], free frozen plasma from 3.1 ± 3.3 to 0.4 ± 1.0 [p < 0.001] and platelets from 2.9 ± 3.9 to 0.4 ± 0.9 [p < 0.001], transfusion avoidance, 9.7% vs. 29.1% [p < 0.001] and massive transfusion, 14.5% vs. 3.8% [p = 0.001]); we also found a significant improvement in patient outcomes, such, reoperation for bleeding or acute-kidney-failure (8.3% vs. 2.4%, p = 0.015; 33.6% vs. 5.4%, p < 0.001), with a significant reduction in the length of the hospital total stay (40.6 ± 13.8 days vs. 38.2 ± 14.4 days, p = 0.001). The lowest cost incurred was observed with the new approach (€73,038.80 vs. €158,912.90) with significant patient saving associated to transfusion avoidance (€1278.36), ICU-stay (€3037.26),total-stay (€3800.76) and reoperation for bleeding (€80,899.64).Conclusions: POC haemostatic monitoring during OLT is cost effective.
%K Blood loss
%K Cost effective
%K Liver transplantation
%K Mobile laboratory
%K Point of care testing
%K Costos y análisis de costo
%K Laboratorios
%K Pruebas en el punto de atención
%K Trasplante de hígado
%K Sangre
%~