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.