title: Use of a saline-coupled bipolar sealer open liver resection for hepatic malignancy: Medical resource use and costs.
abstract: OBJECTIVE
  To evaluate outcomes associated with use of a saline coupled bipolar sealer during open partial liver resection.
  
  
  METHODS
  This retrospective analysis utilized the United States Premier™ insurance claims database (2010-2014). Patients were selected with codes for liver malignancy and partial hepatectomy or lobectomy. Cases were defined by use the saline-coupled bipolar sealer; controls had no use. A Propensity Score algorithm was used to match one case to five controls. A deviation-based cost modeling (DBCM) approach provided an estimate of cost-effectiveness.
  
  
  RESULTS
  One hundred and forty-four cases and 720 controls were available for analysis. Patients in the case cohort received fewer transfusionsvscontrols (18.1%vs29.4%,P= 0.007). In DBCM, more patients in the case cohort experienced "on-course" hospitalizations (53.5%vs41.9%,P= 0.009). The cost calculation showed an average savings in total hospitalization costs of $1027 for casesvscontrols. In multivariate analysis, cases had lower odds of receiving a transfusion (OR = 0.44, 95%CI: 0.27-0.71,P= 0.0008).
  
  
  CONCLUSIONS
  Use of a saline-coupled bipolar sealer was associated with a greater proportion of patients with an "on course" hospitalization.
authors.affiliation: Christine I Nichols, Joshua G Vose, Medtronic Advanced Energy, 180 International Drive, Portsmouth, NH 03801, United States.
authors.forename: Christine I
authors.initials: CI
authors.lastname: Nichols
authors.affiliation: Christine I Nichols, Joshua G Vose, Medtronic Advanced Energy, 180 International Drive, Portsmouth, NH 03801, United States.
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Vose
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D004598:Electrosurgery / Q000191:economics / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000191:economics / Q000379:methods*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology*; D057216:Propensity Score; D012189:Retrospective Studies; D055815:Young Adult
keywords: Costs; Hepatocellular carcinoma; Liver resection