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Liz Stokesby Elizabeth Stokes, HERC.

Results have published in the New England Journal of Medicine of a randomised controlled trial, funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme, which compared policies of transfusing cardiac surgery patients at a low or a higher haemoglobin level.been 

This trial was led by academics at the University of Bristol, but included researchers from the University of Oxford. Dr Sarah Wordsworth and Elizabeth Stokes at the Health Economics Research Centre in the Nuffield Department of Population Health conducted the economic evaluation for the trial.

This trial is one of a number of successful collaborations between Barnaby Reeves, Professorial Research Fellow in Health Services Research in the School of Clinical Sciences at the University of Bristol and Sarah Wordsworth, Associate Professor of Health Economics; collaborations that began more than 8 years ago.  Elizabeth Stokes has been involved in several of these collaborations in the area of cardiac surgery, together with Gavin Murphy, British Heart Foundation (BHF) Professor of Cardiac Surgery, formerly of Bristol’s School of Clinical Sciences and now at the University of Leicester, who led this trial.

Further details of the trial and clinical findings have already been presented here.  The costs associated with the two transfusion strategies were also compared. Detailed data were collected on all significant health and social care inputs for the trial patients in hospital and up to 3 months after surgery, to enable the cost of this care to be calculated.  There was a clear difference in the costs of red blood cell transfusions between the groups: average costs were £287 in the ‘low’ group and £427 in the ‘high’ group.  When all health care costs up to 3 months after surgery (excluding the cost of the index surgery) were considered however, costs were similar in the ‘high’ and ‘low’ groups (on average, £10,636 in the ‘low’ group and £10,814 in the ‘high’ group).

Patients having heart surgery do not benefit if doctors wait until a patient becomes substantially anaemic before giving a transfusion.