The clinical and cost effectiveness of
thromboelastography/thromboelastometry
About the assessment
This Health Technology Assessment (HTA) reports on the clinical
and cost effectiveness of using thromboelastography and
thromboelastometry analysers compared with standard laboratory
tests/assays and clinical discretion alone, to improve the
diagnosis and subsequent management of patients experiencing
unexplained blood loss during or after surgery.
Background
Thromboelastography and thromboelastometry are diagnostic point
of care tests that measure multiple risk factors for coagulation,
including initial clotting, platelet interaction and fibrinolysis
in a sample of whole blood. They are used to assist with the
diagnosis and management of haemostasis disorders, primarily during
and after surgery that is associated with high blood loss. The
complete results take up to 20 minutes to produce and inform on the
presence and type of coagulation disorders. Treatment for such
disorders may involve the transfusion of red blood cells and blood
products. Timely and accurate diagnostic information should allow
clinicians to take effective steps to manage the blood loss.
Results and conclusions
Thromboelastography/thromboelastometry, currently used in five
Scottish hospitals, appears to be a cost-effective intervention. It
has the potential to reduce the need for inappropriate transfusions
and can decrease blood product requirements; this is likely to be
welcomed by patients. Overall,
thromboelastography/thromboelastometry appears to have a positive
impact on patients¿ health by reducing the number of deaths,
complications and infections, and increasing the number of life
years and QALYs.
A further consequence observed was the reduction in the
associated costs, related to the decrease in the number of
transfusions, in the average usage of blood products and in the
healthcare resources needed to deal with complications and
infections. The results of the budget impact analysis showed that
both for patients undergoing cardiac surgery and liver
transplantation, savings are expected if thromboelastography/
thromboelastometry, instead of standard laboratory tests, is used
for their management.
A summary of the recommendations contained within the HTA report
is available here -
Understanding our Advice
This booklet has been produced to explain our advice on the use
of thromboelastography/thromboelastometry to people who do not have
specialist knowledge in this area. It explains what
thromboelastography/thromboelastometry is, how we formed our advice
and the evidence we considered.
Understanding our Advice (PDF, 149K,
20secs)
Further information
For further information, or to receive a copy of the published
report, please contact Doreen Pedlar at Doreen.Pedlar@nhs.net.
Published Date: 20 June 2007
