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Updated: May 10, 2025

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care

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Continuous Intraoperative Hemodynamic Monitoring Decreases In-Hospital Costs.

Leah Y Carreon¹, Steven D Glassman¹, Desiree Chappell²

¹Norton Leatherman Spine Center, Louisville, KY.

|April 22, 2025

Summary

Predictive Hemodynamic Monitoring (PHM) use in spine fusions reduces intra-operative instability and length of stay. This approach may lead to significant cost savings of approximately $2,500 per case.

Keywords:

complications cost minimization fluid management intraoperative hemodynamic instability intraoperative hypotension posterior instrumented spine fusion predictive hemodynamic monitoring thoracolumbar fusion

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Area of Science:

Anesthesiology
Neurosurgery
Health Economics

Background:

Predictive Hemodynamic Monitoring (PHM) has been shown to reduce intra-operative hypotension, complications, and length of stay during posterior spine fusions.
Optimizing intra-operative conditions is crucial for patient outcomes and institutional resource management.

Purpose of the Study:

To evaluate the cost-effectiveness of implementing Predictive Hemodynamic Monitoring (PHM) in elective multi-level instrumented posterior thoracolumbar fusion procedures.
To determine if PHM utilization translates into institutional cost savings.

Main Methods:

A retrospective comparative cohort study was conducted, comparing adult patients undergoing posterior thoracolumbar fusion with PHM (N=47) to those without (Non-PHM, N=70).
Propensity-matched analysis (N=41 per group) was used to control for confounding variables.
Cost data were stratified into surgical, post-operative, and 90-day post-discharge periods.

Main Results:

The PHM group experienced significantly shorter durations of intra-operative hypotension and hypertension.
A statistically significant decrease in length of stay was observed in the PHM group (4.5 vs. 7.0 days).
Post-operative costs were significantly lower in the PHM group, primarily driven by reduced Room & Board, Pharmacy, Labs, and Therapy expenses, resulting in an estimated $2,500 cost saving per case.

Conclusions:

Predictive Hemodynamic Monitoring (PHM) effectively reduces intra-operative hemodynamic instability during posterior spine fusions.
PHM is associated with a decreased length of stay and may lead to substantial cost savings for healthcare institutions.
The findings support the integration of PHM into surgical protocols to improve patient care and financial efficiency.