Cost-Effectiveness of Cell Salvage in Trauma Blood Transfusions.

INTRODUCTION: Despite the increasing amount of evidence supporting its use, cell salvage (CS) remains an underutilized resource in operative trauma care in many hospitals. We aim to evaluate the utilization of CS in adult trauma patients and associated outcomes to provide evidence-based recommendations. METHODS: A systematic review was conducted using PubMed, Google Scholar, and CINAHL. Articles evaluating clinical outcomes and the cost-effectiveness of trauma patients utilizing CS were included. The primary study outcome was mortality rates. The secondary outcomes included complication rates (sepsis and infection) and ICU-LOS. The tertiary outcome was the cost-effectiveness of CS. RESULTS: This systematic review included 9 studies that accounted for a total of 1119 patients that received both CS and allogeneic transfusion (n = 519), vs allogeneic blood transfusions only (n = 601). In-hospital mortality rates ranged from 13% to 67% in patients where CS was used vs 6%-65% in those receiving allogeneic transfusions only; however, these findings were not significantly different (P = .21-.56). Similarly, no significant differences were found between sepsis and infection rates or ICU-LOS in those patients where CS usage was compared to allogeneic transfusions alone. Of the 4 studies that provided comparisons on cost, 3 found the use of CS to be significantly more cost-effective. CONCLUSIONS: Cell salvage can be used as an effective method of blood transfusion for trauma patients without compromising patient outcomes, in addition to its possible cost advantages. Future studies are needed to further investigate the long-term effects of cell salvage utilization in trauma patients.

Analysis of Electric Vehicle Collisions in the United States: An Epidemiological Study.

INTRODUCTION: Despite the increase in electric vehicle sales in the US, their impact on injuries and fatalities is still understudied. We aim to evaluate injuries and fatalities associated with electric vehicle collisions in the US. METHODS: The study utilized electric vehicle injury and fatality data from the Fatality Analysis Reporting System (FARS). All electric vehicle models available within the FARS database and sold in the US from 2014 to 2020 were selected. Electric vehicle models were matched to analogous motor vehicles when possible. RESULTS: No significant increase in electric vehicle fatality per capita (FPC) was found during the study period (2014: .41 vs 2020: 1.42, per 100 000 electric cars, P = .080). However, 82% of all fatalities occurred on non-intersectional local roadways with 46% occurring in the presence of speeding, 14% in the presence of fire, and 38% involving a driver with an elevated blood alcohol content (BAC). The Tesla Model S, Kia Niro, and Hyundai IONIQ accounted for the most fatality per capita (17.89 vs 10.27 vs 8.42, per 100 000 electric cars). Upon comparison of electric vehicles to analogous motor vehicles produced within the same year, the Hyundai IONIQ had a significantly lower FPC compared to the Hyundai Elantra (7.33 vs 23.51, per 100 000 electric cars P = .034). CONCLUSION: While no significant increase in electric vehicle fatality per capita (FPC) was found, the total number of electric vehicle fatalities did increase significantly during the study period (2014-2020). Furthermore, a significant proportion of these fatalities is directly related to speeding, fire, and intoxicated driving.