BACKGROUND: The return of joint drainage after hip and knee arthroplasty is
a widely used but expensive blood-conservation technique.
STUDY DESIGN AND METHODS: A Markov decision analysis model was used to eval
uate the cost-effectiveness of postoperative RBC recovery in preventing vir
al complications of allogeneic transfusion.
RESULTS: In the baseline analysis, using an RBC-recovery device saves 5 qua
lity-adjusted minutes of longevity at an average incremental cost of $53. T
his corresponds to $5.7 million per quality-adjusted life year. This figure
was most sensitive to the direct cost differences of allogeneic versus rec
overed RBCs and to the volume of RBCs recovered per device. Such devices wo
uld save health care resources if they cost less than $73 or if they were a
pplied only in cases where joint drainage was between 600 and 1100 mi.
CONCLUSION: For most clinical situations, postarthroplasty RBC recovery doe
s not appear to be as cost-effective as most other medical interventions. C
linical attention should be directed toward developing protocols for the pr
eferential use of postoperative RBC-recovery devices in situations where th
ey provide the greatest benefit.