Observational evaluation of outcomes and resource utilization from hemostatic matrices in spine surgery

Abstract

The results from this analysis indicated that surgery time, risk of blood transfusion, and amount of matrix used are greater with Surgiflo patients, compared to Floseal patients. Choice of matrix did not appear to impact hospital LOS or risk of surgical complications. Future research should evaluate the cost consequences of increased clinical and resource utilization by choice of hemostatic matrix in spine surgery.

Cost-consequence analysis of two different active flowable hemostatic matrices in spine surgery patients

“…Inadequate hemostasis may lead to significant blood loss during surgery, which is associated with poor intra-operative and post-operative patient outcomes, including the need for blood product transfusions, the need for surgical revision, increased risk of infection and shock, and increased mortality [1][2][3][4][5] . Topical hemostatic agents have been developed and are indicated to control blood loss when traditional surgical methods, such as suture, cautery, or ligature, fail to control bleeding or are inappropriate to use 3 .…”

“…There has been a dearth of publications assessing the comparative clinical effectiveness and cost of FLOSEAL and SURGIFLO in spinal surgery, but recent retrospective analyses have assessed population-based spinal surgery outcomes and costs using national hospital billing datasets 4,12 . The David et al 13 analysis evaluated outcomes and costs, but restricted to a patient population undergoing spinal fusions or refusions, which tend to be shorter and less complicated surgeries.…”

“…The David et al 13 analysis evaluated outcomes and costs, but restricted to a patient population undergoing spinal fusions or refusions, which tend to be shorter and less complicated surgeries. Price et al 4 evaluated comparative surgical outcomes in the full range of spinal surgery indications: fusions/refusions, resections, stabilizations and corpectomies, relevant to flowable hemostatic agent use. The Price et al 4 study showed that, in major spine surgeries, SURGIFLO use was associated with significantly higher risk of blood product transfusion (OR ¼ 2.56, p < 0.001), longer surgery time (8.84 min, p < 0.0001), and increased product usage (1.9 mL, p < 0.001) (FLOSEAL) 4 .…”

“…Price et al 4 evaluated comparative surgical outcomes in the full range of spinal surgery indications: fusions/refusions, resections, stabilizations and corpectomies, relevant to flowable hemostatic agent use. The Price et al 4 study showed that, in major spine surgeries, SURGIFLO use was associated with significantly higher risk of blood product transfusion (OR ¼ 2.56, p < 0.001), longer surgery time (8.84 min, p < 0.0001), and increased product usage (1.9 mL, p < 0.001) (FLOSEAL) 4 . In severe spine surgeries, SURGIFLO was associated with significantly longer OR time (26.94 min, p < 0.001) 4 .…”

“…The Price et al 4 study showed that, in major spine surgeries, SURGIFLO use was associated with significantly higher risk of blood product transfusion (OR ¼ 2.56, p < 0.001), longer surgery time (8.84 min, p < 0.0001), and increased product usage (1.9 mL, p < 0.001) (FLOSEAL) 4 . In severe spine surgeries, SURGIFLO was associated with significantly longer OR time (26.94 min, p < 0.001) 4 . This follow-up analysis aims to determine whether the clinically significant outcome differences in the Price et al 4 study, which compared FLOSEAL and SURGIFLO, result in cost differentials for US payers and hospitals.…”