OBJECTIVES: To identify the economic impact of bleeds and transfusions analyzing the hemostatic agents (active and passive) focusing on adults in the US Hospitals undergoing Cardio Vascular/Thoracic & Ortho-Ortho Spine surgeries.

METHODS: A Retrospective Data Life Utilization Review (LUR) (111 medical records Cardio Vascular/Thoracic & Ortho-Ortho Spine surgeries), performed between August-December 2018, from different US Urban Hospitals; to analyze the quantity of bleedings and transfusions associated with the efficiency of hemostat products to determine the economic impact of bleeds and transfusions.

RESULTS: Of the 111 medical records analyzed, 157 hemostatic agents were used; according the utilization, products such as Flowable and Sealants had a very good efficiency of 80% (95% and 83% respectively), followed by Gelatin Powder (76%), Oxidized Cellulose (72%) as products with medium average efficiency and Hemostats (Thrombin 46%, Gelatin Sponge & Bone Wax (42%) with a low efficiency. The estimated average blood loss for all surgeries was 455 mL and the total amount of blood products used was Pure Red Blood Cells (PRBC) 12, Fresh Froze Plasma (FFP) and Platelets 10, Cryoprecipitate 52. The economic impact of bleeding and transfusion range were from $19,213 to $50,081, depending on the surgery and the hemostat agent used.

CONCLUSIONS: Surgical bleeds, leakages and transfusions have substantial financial and medical consequences. The prevention of these will therefore be beneficial for institutions and patients. Reducing the need for blood transfusions by reducing blood loos during surgery using efficiently the different hemostat agents, would eliminate wasteful utilization of resources and likely improve patient post-surgical outcomes. Hospitals in the US, they estimate, can save money by eliminating these transfusions.