Reduction in hospital costs and resource consumption associated with the use of advanced topical hemostats during inpatient procedures

Abstract

Objective:

The use of hemostatic agents has increased over time for all surgical procedures. The purpose of this study was to evaluate the newer topical absorbable hemostat products Surgicel Fibrillar and Surgicel SNoW (Surgicel advanced products, abbreviated as SAPs) compared to the older product Surgicel Original (SO) with respect to healthcare resource use and costs in procedures where these hemostats are most commonly used.

Research design and methods:

A retrospective analysis of the Premier hospital database was used to identify adults who underwent brain/cerebral (BC), cardiovascular (CV: valve surgery and coronary artery bypass graft) and carotid endarterectomy (CEA) between January 2011–December 2012. Among these patients, those treated with SAPs were compared to those treated with SO. Propensity score matching (PSM) was used to create comparable groups to evaluate differences between SAPs and SO.

Main outcome measures:

The primary end-points for this study were length of stay (LOS), all-cause total cost, number of intensive care unit (ICU) days, ICU cost, transfusion costs and units, and SO/SAP product units per discharge.

Results:

Matched PSM created patient cohorts for SO and SAPs were created for BC (n = 758 for both groups), CV (n = 3388 for both groups), and CEA (n = 2041 for both groups) procedures. Patients that received SAPs had a 14–16% lower mean LOS for each procedure compared to SO, as well as 12–18% lower total mean cost per discharge for each procedure (p < 0.02 for all results). Mean ICU costs for SAPs were also lower, with a reduction of 20% for BC and 19% for CV compared to SO (p < 0.01). However, for CEA, there was no statistically significant difference in ICU costs for SAPs compared to SO.

Conclusions:

In a retrospective hospital database analysis, the use of SAPs were associated with lower healthcare resource utilization and costs compared to SO.

Keywords::

• Hemostats
• Hemostatic techniques
• Blood transfusion
• Healthcare costs
• Blood loss
• surgical

Transparency

Declaration of funding

This study was funded by Ethicon, Inc.

Declaration of financial/other relationships

RK, SL, JR, and MC are all shareholders of Johnson & Johnson and employees of Ethicon, Inc. DM, LM, GM, KP, YR, JS, and YS are all consultants for Johnson & Johnson. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Notice of Correction:

The version of this article published online ahead of print on 26 Mar 2015, contained an error on page 2. On avarage ∼70% of surgeries include the use of hemostatic agent. The percentage “70%” should have read “30%”. The error has been corrected for this version.

Notes

*Surgicel is a registered trademark of Ethicon, Inc., Somerville, NJ

†Fibrillar is a trademark of Ethicon, Inc, Somerville, NJ

‡SNoW is a trademark of Ethicon, Inc, Somerville, NJ

*Nu-Knit is a trademark of Ethicon, Inc, Somerville, NJ