PMD47 IMPACT OF SURGICEL ON SURGICAL OUTCOMES AND HOSPITAL COSTS ASSOCIATED WITH INTRACRANIAL SURGERIES IN A CHINESE TIER III TERTIARY CARE HOSPITAL

Abstract

To assess the real-world impact of Surgicel on surgical outcomes and hospital costs of intracranial surgeries in a Chinese tier III hospital. The patients receiving intracranial surgeries from January 2015 to December 2017 in a Chinese tier III hospital were identified to create the two study cohorts for the use of Surgicel before April 30, 2016 (Surgicel group) vs. no use of Surgicel (non-Surgicel group) after April 30, 2016. The created two groups were compared for surgical outcomes and hospital costs associated with intranasal endoscopic tumor resection (IETR), craniotomy for non-skull base tumor resection (CNSTR), craniotomy of skull base tumor resection (CSTR), and cerebrovascular surgery (CVS), respectively. Propensity score methods were used for the adjusted comparisons. Of the included 3,002 patients, 753 patients were included in the Surgicel group and 2,249 patients were included in the non-Surgicel group. Adjusted comparisons observed that the Surgicel group was associated with lower perioperative blood transfusion rates for IETR (6.9% vs. 9.9%, p=0.606) and CSTR (37.7% vs. 41.8%, p=0.407) without reaching statistical difference. The Surgicel group was associated with significantly shorter post-surgery hospital stay length (9.4 vs. 9.9 days, p=0.005) for IETR in the adjusted comparison. The adjusted comparisons of the distribution of hospital costs observed obvious trends of less medical costs of medical supplies associated with IETR (¥16,277 vs. ¥20,091, p=0.001, ¥1=US$0.15 as of January 16, 2019) and CNSTR (¥29,668 vs. ¥35,968, p=0.008) in the Surgicel group. The Surgicel group for CNSTR was also associated with significantly lower overall hospital costs (¥82,582 vs. ¥93,806, p=0.002) in the adjusted comparison. Using Surgicel as the hemostatic agent could reduce post-surgery hospital stay length associated with IETR and might lead to less use of medical supplies associated with intracranial surgeries and save overall hospital costs.