Presentation (CTI)

OBJECTIVES: To evaluate clinical and economic outcomes of the use of two ultrasonic energy devices in patients undergoing sleeve gastrectomy (SG)
METHODS: Patient data was extracted from PINC AI™ Healthcare Data. The eligibility included age >=18, with primary elective gastric sleeve procedures, using either corded (CD) or cordless (CL) ultrasonic devices (UD), no use of other energy devices, and discharge between 2019 and 2023. Two analysis groups were evaluated: total SG regardless of the brand of the stapler (Cohort_I), and UD used with a same-brand stapler (Cohort_II). A propensity score (PS) matching method with a caliper of 0.2 and 1:1 nearest neighbor matching for patients who used CDUD and CLUD was performed. PS calculation based on patient and provider characteristics. The Chi-square or Fisher exact test and paired t-test were used to examine the variations in post-matched cases. We applied multivariable general-linear-model analysis for sensitivity analysis.
RESULTS: 24160 admissions were included, 82.3% CDUD and 17.7% CLUD cases. 4268 and 3338 cases were paired for Cohort_I and Cohort_II, respectively. After PS matched, CDUD has higher rates of intensive care unit visits than CLUD in Cohort_I (adjusted rates: CDUD, CLUD: 0.8%, 0.3%, Odds ratio (OR) (95% confidence interval (CI)): 2.78(1.47,5.26), p<0.001) and Cohort_II (0.8%, 0.3%, OR: 2.71(1.31, 5.62), p=0.005). Also, CDUD has higher operating-room time (ORT) than CLUD in both Cohort_I (mean differences: 24 minutes (95% CI: 22, 26), p<0.001) and Cohort_II (21 minutes (18, 23), p<0.001). There is no difference in incidence rates of blood transfusion, bleeding, and 30-day readmission, and total inpatient cost and length of stay between CDUD and CLUD. The sensitivity analyses showed similar results.
CONCLUSIONS: The study shows that CLUD had similar clinical and economic outcomes to CDUD but was more efficient in patients treated with sleeve gastrectomy.