OBJECTIVES: To compare the economic and clinical outcomes of patients treated with current formulation of Surgiflo^® or Floseal during spinal surgery.

METHODS: A retrospective analysis was conducted using Premier Hospital Database (2012-2018Q2). Eligible patients were required to have spinal surgery during an inpatient visit between 1/1/2013-06/1/2018, were ≥18 years old at the time of admission, and had received current formulation of Surgiflo^® or Floseal during surgery. Patients in the two treatment groups were matched using their calculated propensity scores (1:3 variable ratio), surgery year, and type of surgery (i.e., surgery location, fusion level, approach and fusion/refusion type). Outcomes included bleeding events, blood transfusion, length of stay (LOS), intensive care unit (ICU) admission, total costs, surgery duration, and readmission within 30-60-90 days. Outcomes were assessed using descriptive analysis and compared between Surgiflo^® and Floseal groups using generalized estimating equations.

RESULTS: The final study sample included 28,910 patients for each treatment group (mean age=59.2 years; 47% males). In both Floseal and Surgiflo^® groups, approximately 6% of patients required blood transfusions within 0-1 days [odds ratio (OR): 1.03; 95% confidence interval (CI): 0.97-1.10)] and 2% within 2-4 days (OR: 0.85.0; 95%CI: 0.76-0.94) of surgery. Compared to Floseal, patients using Surgiflo^® had lower average cost of hospitalization ($29,949 vs. $30,399 P<0.05), shorter LOS (3.4 vs. 3.5 days, P<0.05), shorter surgery duration (247 vs. 250 minutes, P<0.05), and 5% fewer patients had an ICU admission (OR: 0.55; 95%CI: 0.52-0.58). Other outcomes including bleeding, readmission within 30-60-90 days and mortality were comparable (all P>0.05).

CONCLUSIONS: This study included a large sample of patients undergoing spinal surgery over the past 7 years. The results focus on newer hemostatic matrix formulations and suggest relatively comparable clinical outcomes including blood transfusions across products. Additionally, Surgiflo® use also had lower hospitalization costs compared to Floseal.