Bjerke-Kroll BT. J Arthroplasty. 2014. doi:10.1016/j.arth.2013.10.027.
The use of drains in patients undergoing primary unilateral total hip and total knee arthroplasty increased blood loss, transfusion requirements and overall costs, according to study results.
Researchers identified 1,341 patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) and included 536 THAs and 598 TKAs in the study. Data on procedure, gender, date of birth, length of stay, surgeon, preoperative hemoglobin, all available hemoglobin values throughout the hospital stay, amount and type of all blood products transfused throughout the hospital stay and presence of a drain with any associated output were collected. The researchers also calculated the impact of hospital stay.
Overall, the use of a postoperative drain was associated with $538 additional cost per THA and $455 for TKA. Although the use of a drain increased hospital length of stay for THA, it did not increase the length of stay for TKA, according to study results. Use of a drain increased estimated blood loss, as well as the amount of allogeneic blood transfused in both groups, according to the researchers.
During the 10-week period of the study, the researchers’ institution spent a total of $432,972 for postoperative drain use.
“Additional data regarding surgeon’s justification for drain use, including visualized intraoperative bleeding and patient-specific concern for post-operative bleeding would provide useful information not available in a retrospective analysis,” the researchers wrote.
Disclosure: The authors have no relevant financial disclosures.
