Trends, outcomes, and costs of hemostatic utilization for major urologic surgery

You have accessJournal of UrologyCME1 Apr 2023MP77-01 TRENDS, OUTCOMES, AND COSTS OF HEMOSTATIC UTILIZATION FOR MAJOR UROLOGIC SURGERY Camilo Arenas-Gallo, Patrick Lewicki, Megan Prunty, Aaron Brant, Stephen Rhodes, Spyridon P. Basourakos, Alec Zhu, Ilon Weinstein, Bashir Al Hussein Al Awamlh, and Jonathan E. Shoag Camilo Arenas-GalloCamilo Arenas-Gallo More articles by this author , Patrick LewickiPatrick Lewicki More articles by this author , Megan PruntyMegan Prunty More articles by this author , Aaron BrantAaron Brant More articles by this author , Stephen RhodesStephen Rhodes More articles by this author , Spyridon P. BasourakosSpyridon P. Basourakos More articles by this author , Alec ZhuAlec Zhu More articles by this author , Ilon WeinsteinIlon Weinstein More articles by this author , Bashir Al Hussein Al AwamlhBashir Al Hussein Al Awamlh More articles by this author , and Jonathan E. ShoagJonathan E. Shoag More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hemostatic agents are used to prevent hemorragic complications in surgeries. The national trends in the use and the cost associated with these agents in major urologic procedures are largely unknown. METHODS: This retrospective US analysis used the Premier Healthcare database. Patterns of hemostatic agent use in major urologic surgeries were investigated and correlated with patient and hospital characteristics over the past two decades. Multivariable mixed-effects logistic regression was used to identify predictors of hemostatic agent use. RESULTS: The final patient cohort included 385,261 patient encounters for urologic surgery from 2000 to 2020. In 2020, hemostatic agents were used in 36.91% of prostatectomies, 41.69% of radical nephrectomies, 60.22% of partial nephrectomies and 40.77% of cystectomies. In the multivariable models, For patients undergoing prostatectomy odds for receiving hemostatic agent was 14% higher in Hispanic men (OR 1.07, CI 1.22- 1.24; p<0.001) and 7% lower in Black patients men (OR 0.93, CI 0.90- 0.97; p<0.001), 33% lower for open surgery compared to laparoscopic/robotic approach (OR 0.67, 95% CI 0.63- 0.71; p<0.001). For radical nephrectomy patients, odds of receiving hemostatic agent were 16% higher for open approach (OR 1.16, 95% CI 1.12- 1.21; p<0.001), 7% lower for Black race (OR 0.93, 95% CI 0.88- 0.99; p 0.014). For partial nephrectomy patients odds for receiving hemostatic were 18% higher for open approach (OR 1.18, 95% CI 1.10- 1.27; p<0.001). The specific cost for hemostatic use did not differ between lap/robotic and open approaches for any procedure. CONCLUSIONS: The use of hemostatic agents has increased markedly in the last decade. Patient characteristics, surgeon, and hospital factors are highly associated with the use of hemostatic agents. Specific costs of the hemostatic and the proportion of the total cost of hospitalization have increased. There is a great need to develop controlled clinical trials capable of demonstrating the true efficacy of hemostatic agents to determine their specific indications. Source of Funding: J.E.S is supported by the Frederick J. and Theresa Dow Fund of the New York Community Trust, the Vinney Scholars Award, and a Damon Runyon Cancer Research Foundation Physician-Scientist Training Award © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1101 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Camilo Arenas-Gallo More articles by this author Patrick Lewicki More articles by this author Megan Prunty More articles by this author Aaron Brant More articles by this author Stephen Rhodes More articles by this author Spyridon P. Basourakos More articles by this author Alec Zhu More articles by this author Ilon Weinstein More articles by this author Bashir Al Hussein Al Awamlh More articles by this author Jonathan E. Shoag More articles by this author Expand All Advertisement PDF downloadLoading ...