MP17-01 Is a Preoperative Type and Screen Required in Patients Undergoing Common Urological Procedures? A Cost-Benefit Analysis

Joshua Volin, Oakland University William Beaumont School of Medicine Medical Student
Patrick Herndon, Oakland University William Beaumont School of Medicine Medical Student
Aviv Spillinger
Patrick Karabon
James Blumline
Deanna Tran
Craig Fletcher, Beaumont Health
Jason Hafron, Beaumont Health



Many institutions rely on historical data to guide preoperative type and screen (T/S) requirements. Our objective was to evaluate the cost-effectiveness of obtaining preoperative T/S for common urological procedures and determine patient and hospital factors associated with receiving blood transfusions.


Retrospective database analysis of the 2006-2015 National (Nationwide) Inpatient Sample (NIS) was performed to identify patients undergoing a variety of urological procedures where T/S is generally obtained. A total of 4,113,144 cases were identified. Transfusion rates were then determined from NIS data, and multivariate regression analyses was used to identify factors associated with transfusions. A cost-effectiveness analysis was performed to determine the incremental cost-effectiveness ratio (ICER) of obtaining preoperative T/S to prevent an emergency-release transfusion (ERT), with a willingness-to-pay threshold of $1,500.


On multivariate modeling, all Elixhauser comorbidities with the exception of obesity were significant associated with transfusion Some examples included chronic blood loss anemia (OR, 6.56, 95% CI, 6.24-6.89), coagulopathy (OR, 2.04; 95% CI, 1.96-2.12), diabetes (OR, 1.26; 95% CI, 1.19-1.33), liver disease (OR, 1.20; 95% CI, 1.13-1.29), pulmonary circulation disorders (OR, 1.38; 95% CI, 1.30-1.47), and metastatic cancer (OR, 2.69; 95% CI 2.54-2.85) (p


Routine preoperative T/S for radical prostatectomy and penile implants does not represent a cost-effective practice for these surgeries using nationally representative data. A selective T/S policy for high risk patients may reduce costs.