The use of epoetin alfa before orthopaedic surgery in patients with mild anaemia. Understanding our advice: the use of epoetin alfa before orthopaedic surgery in patients with mild anaemia

Craig J, Brown H, Eastgate J, Macpherson K, Wilson S
Record ID 32006000899
English
Authors' objectives:

This Health Technology Assessment (HTA) makes recommendations to NHSScotland on the use of epoetin alfa.

Authors' results and conclusions: The clinical evidence showed that administering epoetin alfa before operations was effective at reducing the number of patients who required transfusion compared with placebo and the mean number of units transfused declined by 0.5-0.7 units per patient. However, there was no reduction in the number of units used per transfused patient and hence the benefit was primarily in fewer patients being transfused. None of the studies reported significant differences in length of stay or postoperative infection rates as a result of using epoetin alfa. The studies were in settings with different transfusion policies from those currently in use across Scotland; in particular the standard care arms had higher transfusion rates than those observed in Scotland. It is thus unclear to what extent the clinical effectiveness results can be generalised to Scotland.
Authors' recommendations: Recommendations Epoetin alfa is not recommended for general use by NHSScotland to reduce exposure to allogeneic blood transfusion in patients with mild anaemia prior to major elective orthopaedic surgery. Epoetin alfa is recommended for restricted use within NHSScotland. It is a possible treatment option for patients with mild anaemia prior to major elective orthopaedic surgery who cannot receive blood transfusion, either due to their religious convictions or because suitable blood is unlikely to be available. Resource implications of recommendations These recommendations are not estimated to change resource use in NHSScotland.
Authors' methods: Review
Details
Project Status: Completed
URL for project: http://www.nhshealthquality.org
Year Published: 2006
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Scotland
MeSH Terms
  • Blood Loss, Surgical
  • Costs and Cost Analysis
  • Anemia
  • Epoetin Alfa
Contact
Organisation Name: Quality Improvement Scotland
Contact Address: Delta House, 50 West Nile Street Glasgow G1 2NP Scotland United Kingdom Tel: +44 141 225 6988; Fax: +44 141 221 3262
Contact Name: shtg.hcis@nhs.net
Contact Email: shtg.hcis@nhs.net
Copyright: NHS Quality Improvement Scotland (NHS QIS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.