Cost implications of post-surgical morbidity following blood transfusion in cancer patients undergoing elective colorectal resection: An evaluation in the US hospital setting

Objective: To estimate the cost implications of blood transfusions and related surgical site infections (SSIs) in cancer patients undergoing elective colorectal resection in the hospital setting in the United States (US). Study design: A modelling study was performed from the perspective of the hospital sector, based on published clinical outcomes from a study in Taiwan involving 2809 cancer patients who underwent elective colorectal resection using laparotomy and American treatment patterns. Methods: Data on resource use were retrieved from published literature and from two American hospital centres specialising in colorectal cancer management. Decision analytical modelling was used to estimate the treatment costs and consequences of managing patients undergoing elective colorectal resection with and without blood transfusions. Results: The expected treatment costs of managing patients who required and did not require a blood transfusion were estimated to be $19869 (95% CI: 15797; 23150) and $14586 (95% CI: 14263; 14886) per patient respectively. Expected treatment costs for those patients transfused with 1-3 units and > 3 units of blood were estimated to be $17449 and $22588 per patient respectively. Conclusion: This is one of the first studies to specifically address the cost implications of post-surgical morbidity following colorectal resection in cancer patients. The cost of managing cancer patients undergoing elective colorectal resection who require a blood transfusion is expected to be 36% more than that of non-transfused patients, largely resulting from the development of SSIs.