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

Document Type

Article

Publication Date

10-10-2021

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: 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. METHODS: 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. RESULTS: 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

Volume

7

Issue

3

First Page

205

Comments

American Urological Association 90th Annual Meeting; Burlington, Vermont, October 14-16, 2021

Last Page

2011

DOI

10.1097/JU.0000000000002002.01

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