Flowable gelatin hemostatic matrix gains more clinical benefits in lumbar surgeries
Updated: Sep 5, 2019
Flowable gelatin hemostatic matrix was found to reduce blood transfusion without increasing hospital costs in real-world lumbar surgeries
“Lumbar surgeries are usually associated with significant bleeding that increases surgery complexity and the needs of blood transfusion”
Spinal fusion procedures usually cause significant perioperative blood loss, which is highly linked with surgery complexity and the needs of blood transfusion. Thus, efficient hemostasis plays a critical role in lumbar surgery for perioperative outcomes and hospital costs. Flowable gelatin hemostatic matrix (FGHM), mixing gelatin granules and saline, could conform and reach the narrow surgical fields by the flexible applicator and lead to effective bleeding control in lumbar surgery. FGHM has been widely used in many surgery settings that include lumbar surgery. The real-world surgery cases with the application of FGHM could be used to clarify the real-world impact of FGHM on perioperative outcomes and hospital costs associated with lumbar surgeries.
"Based on 64 pairs of patients with highly comparable baseline characteristics, the use of FGHM could be associated with significantly reduced rate and volumes of blood transfusion during real-world lumbar surgery"
This real-world study was conducted in a top rank tertiary care hospital with a large volume of spine surgery cases in Beijing. The introduction of FGHM in this hospital allowed this study to compare the preoperative outcomes and hospital costs associated with lumbar surgery before and after the introduction of FGHM. The identified patients were used to created 64 propensity score matched pairs for the comparisons of preoperative outcomes related to hemostasis between FGHM and conventional hemostatic agents. The comparisons of the matched pairs observed significantly lower blood transfusion rate (34.4% vs. 64.1%, p=0.005) and lower blood transfusion volume (182.7 ± 312.4 vs. 301.3 ± 281.0 ml, p=0.045), reduced post-surgery drainage tube placement rate (82.8% vs. 93.8%, p=0.046), and shorter postoperative days on antibiotics (6.0 ± 2.6 vs. 7.1 ± 2.4 d, p=0.010) in the matched FGHM group. Though with relatively high acquisition price of FGHM, the use of FGHM for hemostasis in LS did not increase the total hospitalization costs (coefficient -0.001, p=0.972). Thus, this real-world study was another good case study indicating that the gained clinical benefits could save enough medial costs to fully offset the increased acquisition costs of new technology.
For more information about this study, please click here.