title: Real-world outcomes of hemostatic matrices in cardiac surgery.
abstract: 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.
  
  
  METHODS
  Retrospective database analysis of cardiac surgical cases from 2006 to 2012.
  
  
  METHODS
  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.
  
  
  METHODS
  Coronary artery bypass grafting (CABG), aortic, valve, or valvular with CABG surgery cases in which FLOSEAL or SURGIFLO was included.
  
  
  METHODS
  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.
  
  
  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<0.001); surgical revisions (OR 2.01; 95% CI 1.03- 3.94; p = 0.042); transfusions for any blood products (OR 4.90; 95% CI 3.50-6.87; p<0.001); and longer surgery times (adjusted mean difference = 64 minutes, p<0.001) than the FLOSEAL group. There were no significant differences in mortality and LOS. Results were similar in groups B and C.
  
  
  CONCLUSIONS
  These retrospective outcomes suggested FLOSEAL was associated with fewer negative consequences than SURGIFLO in this surgical population.
authors.affiliation: Baxter Healthcare Corporation, Westlake Village, CA. Electronic address: Scott_Tackett@baxter.com.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Tackett
authors.affiliation: Division of Cardiothoracic Surgery, School of Medicine, Indiana University, Indianapolis, IN.
authors.forename: Domenico
authors.initials: D
authors.lastname: Calcaterra
authors.affiliation: Premier Research Services, Charlotte, NC.
authors.forename: Glenn
authors.initials: G
authors.lastname: Magee
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine, Emory University, Atlanta, GA.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Lattouf
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D016208:Databases, Factual; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods* / Q000706:statistics & numerical data*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D006490:Hemostatics
keywords: bleeding; cardiac surgery; hemostasis; outcomes