Impact of Hemostatic Products on Surgery Outcomes

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Questions and Answers

What was the total number of spinal surgeries included in the study?

5,934

8,260

10,716 (correct)

4,616

Which surgical specialties showed significantly higher odds of bleeding complications?

General and knee/hip replacement

Solid organ and vascular

Solid organ, general, knee/hip replacement, reproductive organ, and spinal (correct)

Reproductive organ and spinal

What were patients in the study directly matched on?

Age and surgeon experience

Type of surgery and hospital location

Gender, age, and type of insurance

Surgery code, age categories, and comorbidity scores (correct)

During what time frame were patients analyzed for the inpatient procedures?

From 2017 to 2018 Signup and view all the answers

Which cohort had higher unadjusted rates of bleeding-related complications?

The PA cohort Signup and view all the answers

What was a primary outcome measured in the study aside from bleeding-related complications?

Length of stay (LOS) Signup and view all the answers

Which of the following statements is true regarding the costs observed?

Total hospital costs were higher in the PA cohort across all specialties. Signup and view all the answers

What comorbidity index was used to match patients in the study?

Charlson Comorbidity Index Signup and view all the answers

What was the primary focus of the research conducted by Iannitti et al.?

Bleeding-related complications and hospital costs Signup and view all the answers

Which type of hemostatic product treatment approaches were compared in the study?

Active only and combined passive and active Signup and view all the answers

What is the ISSN provided for the Journal of Medical Economics?

1369-6998 Signup and view all the answers

What is the primary scenario where passive products are most effective?

Minimal bleeding scenarios Signup and view all the answers

In which year was the research by Iannitti and colleagues published?

2021 Signup and view all the answers

What is the primary aim of the hemostatic product treatment approaches discussed?

To decrease bleeding-related complications Signup and view all the answers

What do active hemostatic products do in the coagulation cascade?

Participate at the end of the coagulation cascade Signup and view all the answers

Which type of patients may be ideal candidates for active hemostatic products?

Patients with clotting factor deficiencies Signup and view all the answers

Where do the authors Iannitti, Kim, Ito, and Epstein work?

Atrium Health and Stratevi Signup and view all the answers

What is the volume and issue number in which the article was published?

24:1 Signup and view all the answers

What limitation regarding hemostatic products was mentioned about the Premier database?

Inability to determine costs associated with hemostatic products Signup and view all the answers

Which statement is true regarding the publication of the article?

It was published in a medical journal focused on economics. Signup and view all the answers

What approach do most surgeons typically prefer regarding hemostatic products during surgery?

Utilizing a passive product as first choice Signup and view all the answers

What does a higher CCI score indicate?

Greater likelihood of mortality and resource use Signup and view all the answers

What does the classification of hemostatic products indicate about passive and active cohorts?

They operate at different stages of the coagulation cascade Signup and view all the answers

What type of research approval was required for the analysis conducted?

No approval was required for the analysis Signup and view all the answers

What was utilized during the index hospitalization for patients in the active hemostat cohort?

Only active hemostatic products Signup and view all the answers

Which condition is NOT listed as a comorbidity in the study?

Asthma Signup and view all the answers

Which coagulopathy is not ideal for using active hemostatic products?

Patients on antithrombotic medications Signup and view all the answers

What was the purpose of standardizing total hospital costs to 2019 US Dollars?

To compare costs accurately across different years Signup and view all the answers

Which software was used for the statistical analyses in the study?

R version 3.6.0 Signup and view all the answers

What types of surgeries were included in the patient population for the study?

Various types including cardiac and spinal surgeries Signup and view all the answers

What does a CCI score of zero signify?

No comorbidity present Signup and view all the answers

What was one of the key outcomes evaluated in the study?

Occurrence of bleeding-related complications Signup and view all the answers

What is the primary objective of the analysis mentioned?

To identify the most beneficial treatment approach for intraoperative bleeding Signup and view all the answers

Which categories are used for assessing patient age in this analysis?

0–17, 18–45, 46–64, 65þ Signup and view all the answers

What does the Charlson Comorbidity Index (CCI) measure in this context?

Severity of comorbid conditions Signup and view all the answers

How many inpatient admissions does the Premier US Perspective Hospital Database capture annually?

Approximately 8 million Signup and view all the answers

Which of the following is NOT listed as a patient demographic variable in the analysis?

Socioeconomic status Signup and view all the answers

Which pre-operative factors were evaluated during the index hospitalization?

Pre-/peri-operative antiplatelet/anticoagulant use Signup and view all the answers

What database is utilized for this retrospective observational analysis?

Premier US Perspective Hospital Database Signup and view all the answers

What is evaluated during the pre-index period?

Clinical characteristics from 12 months prior to hospitalization Signup and view all the answers

Study Notes

Study Aim

To compare the impact of active hemostatic products (A), or combined passive and active hemostatic products (PA), on bleeding-related complications and cost among inpatient surgeries.

Sample and Methods

Retrospective analysis of the US Premier Hospital Database of patients undergoing inpatient surgeries.
Analysis includes surgeries in cardiac, vascular, noncardiac thoracic, solid organ, general, reproductive organ, knee & hip replacement, spinal, and neurosurgery.
Data collected between January 1, 2017 and December 31, 2018.
Patients groups (A & PA) matched 1:1 by surgery code, age, and Charlson Comorbidity Index score.
Outcome data includes unadjusted and adjusted rates of bleeding complications, length of stay, and total hospital costs.

Key Findings

Higher unadjusted rates of bleeding complications, length of stay, and total hospital costs were observed in the PA cohort versus the A cohort across all specialties.
Adjusted odds ratios for bleeding complications were significantly higher in the PA cohort for: solid organ surgery, general surgery, knee & hip replacement surgery, reproductive organ surgery, and spinal surgery.
The results suggest that an active hemostatic product treatment approach may be more beneficial in terms of bleeding complications and hospital costs.

Limitations

Not all patients had demographic and clinical characteristics reported.
It was impossible to determine which hemostatic product was used for each specific procedure for patients who underwent multiple procedures.
Only surgeries with one ICD-10 PCS code for hospitalization were included.

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Description

This quiz evaluates the effects of active versus combined hemostatic products on bleeding complications and costs in inpatient surgeries. It is based on a retrospective analysis of data from various surgical specialties and highlights the key findings from the study. Test your understanding of these medical findings and their implications for patient care.