Key result
Preoperative iron-deficiency anaemia in patients undergoing elective surgery was associated with a significantly increased risk of mortality compared to patients without iron-deficiency anaemia (RR 3.630).
Why the study?
To quantify the potential epidemiological and health economic benefits of implementing preoperative anaemia measures in clinical practice in the German healthcare system.
Does the implementation of preoperative anaemia measures (PAMs) reduce mortality, hospital stay, and healthcare costs in patients undergoing elective surgery?
Observational (n=4,591,060)
Does the implementation of preoperative anaemia measures (PAMs) reduce mortality, hospital stay, and healthcare costs in patients undergoing elective surgery?
Relative Risk: 3.63 (95% CI 3.401–3.874)
Implementing preoperative anaemia measures for patients undergoing elective surgery in Germany could significantly reduce mortality, hospital length of stay, and healthcare costs.
May support PAM exploration to reduce elective surgery costs and deaths; leaves open prospective validation of modeled estimates.
INTRODUCTION: This study aimed to quantify the potential epidemiological and health economic benefits of implementing preoperative anaemia measures (PAMs) in clinical practice in the German healthcare system. METHODS: An evidence-based health economic model was developed to assess the possible impact of implementing PAMs, the first pillar of patient blood management (PBM), in a German population. The analysis of two risk factors-iron-deficiency anaemia (IDA) and receipt of a red blood cell concentrate (RBC) transfusion during elective surgery-allowed the estimation of relative risks (RRs), average cost per patient, average length of hospital stay, and avoided hospital deaths after the implementation of PAMs. RESULTS: A total of 4,591,060 patients who had undergone elective surgery during 2015 were identified, of which 29,170 (0.64%) were diagnosed with preoperative IDA. These patients had an increased RR of receiving a RBC transfusion during surgery (RR 5.031; 95% confidence interval [CI] 4.928, 5.136) and increased mortality risk (RR 3.630; 95% CI 3.401, 3.874) versus patients without IDA. Patients who received a RBC transfusion during surgery had a 24.6-times higher risk of death than those who did not (RR 24.593; 95% CI 24.121, 25.075). Average cost of treatment was €7883 in patients with IDA, €21,744 in patients with IDA and RBC transfusion, and €4560 in patients without risk factors. The model identified 29,714 patients (0.65%) who had received a RBC transfusion and who potentially had IDA but remained undiagnosed before surgery. Hypothetical implementation of PAMs would have resulted in an estimated annual net hospital direct cost saving of €1029 million (1.58%) of total hospital direct costs of the German healthcare system and 3036 hospital deaths (0.07%) avoided. CONCLUSIONS: This model estimated the impact of implementing PAMs for patients with IDA undergoing elective surgery. A significant number of deaths, costly treatments, and hospital days could have been avoided by the introduction of PAMs in routine clinical practice in Germany.
No takes yet. Share an insight, caveat, or question.
Drabinski et al. (2020) conducted an observational in Preoperative iron-deficiency anaemia (n=4,591,060). Iron-deficiency anaemia (IDA) vs. No IDA was evaluated on Mortality risk (RR 3.630, 95% CI 3.401, 3.874). Preoperative iron-deficiency anaemia in patients undergoing elective surgery was associated with a significantly increased risk of mortality compared to patients without iron-deficiency anaemia (RR 3.630).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: