Quantra Q-plus Point of Care Coagulation Analysis Reduces Blood Product Cost Burden in Patients Undergoing Cardiac Surgery

Background: Despite long standing blood management guidelines for cardiac surgery, VET is underutilized, and fewer institutions employ new real-time operating room-based POC-VET. We evaluated the cost effects of POC-VET coagulopathy management at a single institution when the technology was implemented. Hypothesis: The hypothesis was that POC-VET-guided reduction in blood transfusion, wastage, and pro-thrombotic pharmaceuticals generated cost savings. Methods: 596 patients were analyzed from a time prior to POC-VET coagulation management and 253 after implementing the Quantra Qplus system (Hemosonics LLC). Blood component and pharmaceutical costs were estimated from available literature to develop blood acquisition costs, two models of total hospital blood costs and pharmaceutical costs. All models were standardized to 500 patients. Results: Estimated direct acquisition costs of components were reduced by 16%, from $643,610 (Pre-PBM) to $540,500 (PBM-Quantra) per 500 patients. Estimated total hospital costs of transfusions were reduced between 17.5-18.3% (Model 1: $2,488,418 Pre-PBM vs. $2,053,900 PBM-Quantra; Model 2: $3,868,840 Pre-PBM vs. $3,159,525 PBM-Quantra). Estimated direct costs for blood component wastage were reduced by 86.2% ($175,000 PRE-PBM vs $24,195 PBM-Quantra per 500 patients). Estimated total costs for blood product were reduced by 86.2-85.8% (Model 1: $665,076 Pre-PBM vs. $91,941 PBM-Quantra; Model 2: $1,031,157 Pre-PBM Quantra vs $146,687 PBM-Quantra, all per 500 patients.) Pharmaceutical costs were reduced from $226,353 to $162,740 per 500 patients. Overall combined amortize savings per patient were between $635 to $3,315. Conclusions : This study showed that adoption of the Quantra Qplus POC-VET resulted in significant cost savings of unnecessary transfusions, less ordering of coagulation components and pro-coagulant pharmaceuticals. Cost containment and effective allocation of limited resources such as blood component is paramount to PBM.