Reduction in costs, blood products, and operating time in patients undergoing open heart surgery

Objective: To test the hypothesis that use of aprotinin at half dose would be more cost-effective or as efficacious as full-dose aprotinin or no aprotinin during open heart surgery. Design: Cost-effective analysis, unmasked prospective comparison; Setting: Community hospital. Patients: One hundred thirty-three patients undergoing open heart surgery. Interventions: Patients in 3 consecutive groups undergoing open heart surgery were allocated to receive no aprotinin, full-dose aprotinin, or half-dose aprotinin. Main Outcome Measures Total cost (in dollars) of blood products administered plus cost of aprotinin at various dosages, comparison of total blood products administered during hospitalization, and closure time required in the operating room. Results: Full-dose and half-dose aprotinin significantly (P<.05) reduced the total blood products administered during hospitalization and the operating room closure time. However, use of half-dose aprotinin resulted in a significant cost savings (P<.05) when compared with either the cost of blood products required in the nodose aprotinin group or the cost of blood products plus aprotinin in the full-dose aprotinin group. Conclusion: Use of aprotinin al half dose in a community hospital resulted in a significant reduction in costs, blood product use, and operating room closure time in patients undergoing open heart surgery.