Choice of Hemostatic agent and hospital length of stay in cardiovascular surgery

Sangeeta Krishnan; Therese M. Conner; Ryan Leslie; Stephen Stemkowski; Aryeh Shander

doi:10.1177/1089253209351321

Choice of Hemostatic agent and hospital length of stay in cardiovascular surgery

Sangeeta Krishnan
, Therese M. Conner
, Ryan Leslie
, Stephen Stemkowski
, Aryeh Shander

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

Hemostatic agents (HAs) are efficacious in reducing blood loss during surgery, which may affect postoperative length of stay (LOS). The purpose of this study was to compare the expected and actual LOS by HA in cardiac procedures. Hospital claims data between 2003 and 2006 were extracted from a US service-level comparative database. Four cohorts for comparison were FLOSEAL, SURGICEL + thrombin, GELFOAM + thrombin, and other. Expected LOS was derived using 2006 Centers for Medicare and Medicaid LOS by diagnosis-related group, and 2-part regression models were created to assess outcome. A total of 36 950 discharges were included. FLOSEAL was associated with less likelihood of exceeding expected LOS compared with baseline (odds ratio = 0.791; P <.01). Among patients who did exceed expected LOS, FLOSEAL patients did so at a reduced rate (incidence rate ratio = 0.891; P <.01). Further assessment is warranted to distinguish products with favorable outcomes.

Original language	English
Pages (from-to)	225-230
Number of pages	6
Journal	Seminars in Cardiothoracic and Vascular Anesthesia
Volume	13
Issue number	4
DOIs	https://doi.org/10.1177/1089253209351321
State	Published - Dec 2009
Externally published	Yes

Keywords

Cardiovascular surgery
Hemostat
Therapeutic impact

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10.1177/1089253209351321

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@article{477b08a9f47549eda4a9faabdc8b29eb,

title = "Choice of Hemostatic agent and hospital length of stay in cardiovascular surgery",

abstract = "Hemostatic agents (HAs) are efficacious in reducing blood loss during surgery, which may affect postoperative length of stay (LOS). The purpose of this study was to compare the expected and actual LOS by HA in cardiac procedures. Hospital claims data between 2003 and 2006 were extracted from a US service-level comparative database. Four cohorts for comparison were FLOSEAL, SURGICEL + thrombin, GELFOAM + thrombin, and other. Expected LOS was derived using 2006 Centers for Medicare and Medicaid LOS by diagnosis-related group, and 2-part regression models were created to assess outcome. A total of 36 950 discharges were included. FLOSEAL was associated with less likelihood of exceeding expected LOS compared with baseline (odds ratio = 0.791; P <.01). Among patients who did exceed expected LOS, FLOSEAL patients did so at a reduced rate (incidence rate ratio = 0.891; P <.01). Further assessment is warranted to distinguish products with favorable outcomes.",

keywords = "Cardiovascular surgery, Hemostat, Therapeutic impact",

author = "Sangeeta Krishnan and Conner, \{Therese M.\} and Ryan Leslie and Stephen Stemkowski and Aryeh Shander",

note = "Funding Information: M. Nikpour holds a National Health and Medical Research Council of Australia Career Development Fellowship (APP 1126370). M.E. Schnitzer receives a New Investigator Salary Award from CIHR. The other co-authors have declared no competing interests. Funding Information: The Canadian Scleroderma Research Group (CSRG) is funded by the Ca nadian Institutes of Health Research (CIHR), Scleroderma Canada, the Scleroderma Society of Ontario, Scl{\'e}roder-mie Quebec, the Scleroderma Association of Saskatchewan, Scleroderma Manitoba, the Scleroderma Society of Nova Scotia, the Scleroderma Association of British Columbia, the Cure Scleroderma Foundation, the Canadian Blood and Marrow Transplant Group, and the Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC. The CSRG has also received educational grants from Acte-lion Pharmaceuticals and Mallinckrodt. The Australian Scleroderma Interest Group (ASIG) is supported by Scleroderma Australia, Scleroderma Victoria, Arthritis Australia, Actelion Australia, Janssen Australia, Musculoskeletal Australia, the Australian Rheumatology Association, the Scleroderma Clinical Trials Consortium, St Vincent{\textquoteright}s Hospital Research Endowment Fund, Bayer, GlaxoSmithKline Australia.",

year = "2009",

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doi = "10.1177/1089253209351321",

language = "English",

volume = "13",

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AU - Krishnan, Sangeeta

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AU - Leslie, Ryan

AU - Stemkowski, Stephen

AU - Shander, Aryeh

N1 - Funding Information: M. Nikpour holds a National Health and Medical Research Council of Australia Career Development Fellowship (APP 1126370). M.E. Schnitzer receives a New Investigator Salary Award from CIHR. The other co-authors have declared no competing interests. Funding Information: The Canadian Scleroderma Research Group (CSRG) is funded by the Ca nadian Institutes of Health Research (CIHR), Scleroderma Canada, the Scleroderma Society of Ontario, Scléroder-mie Quebec, the Scleroderma Association of Saskatchewan, Scleroderma Manitoba, the Scleroderma Society of Nova Scotia, the Scleroderma Association of British Columbia, the Cure Scleroderma Foundation, the Canadian Blood and Marrow Transplant Group, and the Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC. The CSRG has also received educational grants from Acte-lion Pharmaceuticals and Mallinckrodt. The Australian Scleroderma Interest Group (ASIG) is supported by Scleroderma Australia, Scleroderma Victoria, Arthritis Australia, Actelion Australia, Janssen Australia, Musculoskeletal Australia, the Australian Rheumatology Association, the Scleroderma Clinical Trials Consortium, St Vincent’s Hospital Research Endowment Fund, Bayer, GlaxoSmithKline Australia.

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N2 - Hemostatic agents (HAs) are efficacious in reducing blood loss during surgery, which may affect postoperative length of stay (LOS). The purpose of this study was to compare the expected and actual LOS by HA in cardiac procedures. Hospital claims data between 2003 and 2006 were extracted from a US service-level comparative database. Four cohorts for comparison were FLOSEAL, SURGICEL + thrombin, GELFOAM + thrombin, and other. Expected LOS was derived using 2006 Centers for Medicare and Medicaid LOS by diagnosis-related group, and 2-part regression models were created to assess outcome. A total of 36 950 discharges were included. FLOSEAL was associated with less likelihood of exceeding expected LOS compared with baseline (odds ratio = 0.791; P <.01). Among patients who did exceed expected LOS, FLOSEAL patients did so at a reduced rate (incidence rate ratio = 0.891; P <.01). Further assessment is warranted to distinguish products with favorable outcomes.

AB - Hemostatic agents (HAs) are efficacious in reducing blood loss during surgery, which may affect postoperative length of stay (LOS). The purpose of this study was to compare the expected and actual LOS by HA in cardiac procedures. Hospital claims data between 2003 and 2006 were extracted from a US service-level comparative database. Four cohorts for comparison were FLOSEAL, SURGICEL + thrombin, GELFOAM + thrombin, and other. Expected LOS was derived using 2006 Centers for Medicare and Medicaid LOS by diagnosis-related group, and 2-part regression models were created to assess outcome. A total of 36 950 discharges were included. FLOSEAL was associated with less likelihood of exceeding expected LOS compared with baseline (odds ratio = 0.791; P <.01). Among patients who did exceed expected LOS, FLOSEAL patients did so at a reduced rate (incidence rate ratio = 0.891; P <.01). Further assessment is warranted to distinguish products with favorable outcomes.

KW - Cardiovascular surgery

KW - Hemostat

KW - Therapeutic impact

UR - https://www.scopus.com/pages/publications/73849121750

U2 - 10.1177/1089253209351321

DO - 10.1177/1089253209351321

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AN - SCOPUS:73849121750

SN - 1089-2532

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JO - Seminars in Cardiothoracic and Vascular Anesthesia

JF - Seminars in Cardiothoracic and Vascular Anesthesia

IS - 4

ER -

Choice of Hemostatic agent and hospital length of stay in cardiovascular surgery

Abstract

Keywords

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