Real-World Outcomes of Hemostatic Matrices in Cardiac Surgery

Tackett, S.; Calcaterra, Domenico; Magee, Glenn; Lattouf, Omar M.

doi:10.1053/j.jvca.2014.05.010

Cited by 26 publications

(49 citation statements)

References 20 publications

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“…The most influential driver of cost, as detailed in the sensitivity analyses, was time spent in the OR performing surgery. This correlates with prior studies showing that FLOSEAL achieves hemostasis faster than SURGIFLO 3,4 . The strength of our analysis is derived from the Price et al 4 comparative effectiveness analysis of which it is based.…”

Section: Discussionsupporting

confidence: 90%

“…Faivre et al 18 reported annual cost savings of e56,000-e344,000 with FLOSEAL use in MSS, and e40,000-e179,000 with FLOSEAL use in SSS in an economic analysis derived from Price et al 4 clinical inputs. Additionally, it is worth noting that our results are in agreement with a similar analysis of hemostatic matrix use in cardiac surgery 3 19 . This line of research has suggested that the differences between these flowable hemostatic agents results in different outcomes, some of which relate to patient safety, in both spine and cardiac procedures.…”

Section: Discussionsupporting

confidence: 89%

“…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 .…”

Section: Introductionmentioning

confidence: 99%

“…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 . In the US, two commonly used gelatin-based hemostatic matrices are FLOSEAL Hemostatic Matrix (Baxter Healthcare Corporation, Deerfield, IL) 6 and SURGIFLO Hemostatic Matrix…”

Section: Introductionmentioning

confidence: 99%

“…Both agents combine passive and active hemostats in a single application product 3 . Gelatin functions as a passive hemostat, inducing hemostasis via platelet activation and mechanical compression.…”

Section: Introductionmentioning

confidence: 99%

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

Makhija

Rock

Ikeme

et al. 2017

Journal of Medical Economics

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Objectives: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery. Methods: A cost consequence model was constructed from a US hospital provider perspective. Model parameters combined clinical inputs from the published retrospective analysis with supplemental analyses on annual spine surgery volume using the 2012 National Inpatient Sample (NIS) database. Cost of hemostatic matrices, blood product transfusion, and operating room time were identified from published literature. Various one-way and probabilistic sensitivity analyses were performed. Results: The base case for a medium volume hospital showed that, compared to SURGIFLO, patients receiving FLOSEAL required three fewer blood product transfusions and saved 27 h of OR time, resulting in annual savings of $151 per major and $574 per severe spine surgery. Additional scenarios for high and low volume hospitals supported cost savings in the base case. Probabilistic sensitivity analysis revealed FLOSEAL was cost-saving in 76% of simulations in major spine and 97% of iterations in severe spine surgery. Conclusions: This economic analysis indicates that use of FLOSEAL instead of SURGIFLO hemostatic matrices to induce hemostasis in both major and severe spine surgery could potentially lead to sizable cost savings in US hospitals, regardless of spinal surgery case-mix. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 90%