Real-World Outcomes of Hemostatic Matrices in Cardiac Surgery

Objective While hemostatic matrices are efficacious in achieving hemostasis, outcomes research is limited; therefore, this study analyzed clinical outcomes of flowable hemostatic matrices in a real-world cardiac surgical population. Design Retrospective database analysis of cardiac surgical cases fr...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2014-12, Vol.28 (6), p.1558-1565
Main Authors: Tackett, Scott M., MHA, MPH, Calcaterra, Domenico, MD, PhD, Magee, Glenn, MBA, Lattouf, Omar M., MD, PhD
Format: Article
Language:English
Subjects:
Aged
Anesthesia & Perioperative Care
bleeding
Blood Loss, Surgical - statistics & numerical data
Blood Transfusion - statistics & numerical data
cardiac surgery
Cardiac Surgical Procedures
Coronary Artery Bypass
Critical Care
Databases, Factual
Female
hemostasis
Hemostasis, Surgical - methods
Hemostasis, Surgical - statistics & numerical data
Hemostatics - therapeutic use
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Odds Ratio
outcomes
Retrospective Studies
Treatment Outcome
United States
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Summary:Objective While hemostatic matrices are efficacious in achieving hemostasis, outcomes research is limited; therefore, this study analyzed clinical outcomes of flowable hemostatic matrices in a real-world cardiac surgical population. Design Retrospective database analysis of cardiac surgical cases from 2006 to 2012. Setting Data were extracted from Premier’s United States (US) Perspective Database, developed for quality and utilization benchmarking and containing approximately 25% of US hospital discharges. Participants Coronary artery bypass grafting (CABG), aortic, valve, or valvular with CABG surgery cases in which FLOSEAL or SURGIFLO was included. Interventions Three study groups were formed, given usage of hemostatic matrices: (1) FLOSEAL or SURGIFLO, exclusively; (2) FLOSEAL or SURGIFLO, with fibrin sealants, sealants, or powder hemostats; and (3) FLOSEAL or SURGIFLO, with nonflowable hemostats with or without thrombin. Outcomes included complications, transfusions, surgical revisions, mortality, length of stay (LOS) and surgery time. Measurements and Main Results Group A included 4,480 FLOSEAL and 326 SURGIFLO cases. Results suggested SURGIFLO cases were associated with significantly higher risk of multiple adverse outcomes, including major (odds Ratio [OR] 2.12; 95% CI 1.34-3.35; p = 0.001) and minor complications (OR 1.84; 95% CI 1.33-2.55; p
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2014.05.010