Radiofrequency bipolar hemostatic sealer reduces blood loss, transfusion requirements, and cost for patients undergoing multilevel spinal fusion surgery: a case control study
| dc.contributor.author | Frank, Steven M. | en |
| dc.contributor.author | Wasey, Jack O. | en |
| dc.contributor.author | Dwyer, Ian M. | en |
| dc.contributor.author | Gokaslan, Ziya L. | en |
| dc.contributor.author | Ness, Paul M. | en |
| dc.contributor.author | Kebaish, Khaled M. | en |
| dc.contributor.department | Biochemistry | en |
| dc.date.accessioned | 2015-11-07T07:02:23Z | en |
| dc.date.available | 2015-11-07T07:02:23Z | en |
| dc.date.issued | 2014-07-05 | en |
| dc.date.updated | 2015-11-07T07:02:23Z | en |
| dc.description.abstract | Background A relatively new method of electrocautery, the radiofrequency bipolar hemostatic sealer (RBHS), uses saline-cooled delivery of energy, which seals blood vessels rather than burning them. We assessed the benefits of RBHS as a blood conservation strategy in adult patients undergoing multilevel spinal fusion surgery. Methods In a retrospective cohort study, we compared blood utilization in 36 patients undergoing multilevel spinal fusion surgery with RBHS (Aquamantys®, Medtronic, Minneapolis, MN, USA) to that of a historical control group (n = 38) matched for variables related to blood loss. Transfusion-related costs were calculated by two methods. Results Patient characteristics in the two groups were similar. Intraoperatively, blood loss was 55% less in the RBHS group than in the control group (810 ± 530 vs. 1,800 ± 1,600 mL; p = 0.002), and over the entire hospital stay, red cell utilization was 51% less (2.4 ± 3.4 vs. 4.9 ± 4.5 units/patient; p = 0.01) and plasma use was 56% less (1.1 ± 2.4 vs. 2.5 ± 3.4 units/patient; p = 0.03) in the RBHS group. Platelet use was 0.1 ± 0.5 and 0.3 ± 0.6 units/patient in the RBHS and control groups, respectively (p = 0.07). The perioperative decrease in hemoglobin was less in the RBHS group than in the control group (−2.0 ± 2.2 vs. –3.2 ± 2.1 g/dL; p = 0.04), and hemoglobin at discharge was higher in the RBHS group (10.5 ± 1.4 vs. 9.7 ± 0.9 g/dL; p = 0.01). The estimated transfusion-related cost savings were $745/case by acquisition cost and approximately 3- to 5-fold this amount by activity-based cost. Conclusions The use of RBHS in patients undergoing multilevel spine fusion surgery can conserve blood, promote higher hemoglobin levels, and reduce transfusion-related costs. | en |
| dc.description.version | Published version | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.citation | Journal of Orthopaedic Surgery and Research. 2014 Jul 05;9(1):50 | en |
| dc.identifier.doi | https://doi.org/10.1186/s13018-014-0050-2 | en |
| dc.identifier.uri | http://hdl.handle.net/10919/63988 | en |
| dc.language.iso | en | en |
| dc.rights | Creative Commons Attribution 4.0 International | en |
| dc.rights.holder | Frank et al.; licensee BioMed Central Ltd. | en |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en |
| dc.title | Radiofrequency bipolar hemostatic sealer reduces blood loss, transfusion requirements, and cost for patients undergoing multilevel spinal fusion surgery: a case control study | en |
| dc.title.serial | Journal of Orthopaedic Surgery and Research | en |
| dc.type | Article - Refereed | en |
| dc.type.dcmitype | Text | en |