PURPOSE Blood transfusion and blood management are important aspects in orthopaedic surgery. Strategies include intra-operative and post-operative blood salvage and even the use of fibrin sealant in selected case. Objectives of the study were (1) to compare the total number of transfusions and the length of hospital stay in patients undergoing complete revision hip arthroplasty (RHA) with and without the use of a fibrin sealant (EVICEL®) and (2) to evaluate the possible role in cost savings of EVICEL® in association with the blood-saving protocol. METHODS Retrospective observational study evaluating patients undergoing complete RHA (stem + cup) with a blood-saving protocol with (n = 50) and without EVICEL® (n = 60). The outcome measures were: number of patients transfused (allogeneic red blood cells-RBC-and plasma), amount of blood/plasma transfusions, quantity of re-infused recycled blood, and length of hospital stay. An economic model was developed to assess the differences in costs between the two groups. RESULTS EVICEL® reduced the number of transfused red blood cells and plasma (p < 0.001), and the hospital stay (p = 0.01) compared to control group. EVICEL® can induce a reduction in resource consumption with an average cost-savings of €1.676 per patient. CONCLUSION EVICEL® may be effective in reducing red blood cells and plasma transfusion as well as hospital stay. The inclusion of EVICEL® in a blood-saving protocol seems to produce clinical efficacy and cost savings.

中文翻译：

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在进行翻修髋关节置换术的患者的节血方案中使用血纤蛋白密封剂：对术后输血和医疗保健相关成本分析的影响。

目的输血和血液管理是整形外科的重要方面。策略包括在术中和术后进行血液挽救，甚至在选定的病例中使用血纤蛋白封闭剂。该研究的目的是（1）比较接受和不采用纤维蛋白封闭剂（EVICEL®）的完全翻修髋关节置换术（RHA）患者的输血总数和住院时间，以及（2）评估结合节省血液的协议，EVICEL®在节省成本方面可能发挥的作用。方法回顾性观察性研究评估了接受完整的RHA（茎干+杯）的患者（有n = 50）和没有EVICEL®（n = 60）的节血方案。结果指标为：输血患者数量（同种异体红细胞-RBC-和血浆），输血/血浆量，重新输注的循环血量和住院时间。开发了一种经济模型来评估两组之间的成本差异。结果与对照组相比，EVICEL®减少了输血的红细胞和血浆的数量（p <0.001），并减少了住院时间（p = 0.01）。EVICEL®可以减少资源消耗，每位患者平均节省成本1.676欧元。结论EVICEL®可有效减少红细胞和血浆输血以及住院时间。将EVICEL®纳入节省血液的方案似乎可以产生临床疗效并节省成本。结果与对照组相比，EVICEL®减少了输血的红细胞和血浆的数量（p <0.001），并减少了住院时间（p = 0.01）。EVICEL®可以减少资源消耗，每位患者平均节省成本1.676欧元。结论EVICEL®可有效减少红细胞和血浆输血以及住院时间。将EVICEL®纳入节省血液的方案似乎可以产生临床疗效并节省成本。结果与对照组相比，EVICEL®减少了输血的红细胞和血浆的数量（p <0.001），并减少了住院时间（p = 0.01）。EVICEL®可以减少资源消耗，每位患者平均节省成本1.676欧元。结论EVICEL®可有效减少红细胞和血浆输血以及住院时间。将EVICEL®纳入节省血液的方案似乎可以产生临床疗效并节省成本。