NOSOCOMIAL BLOOD-STREAM INFECTION IN CRITICALLY ILL PATIENTS - EXCESS LENGTH OF STAY, EXTRA COSTS, AND ATTRIBUTABLE MORTALITY
NOSOCOMIAL BLOOD-STREAM INFECTION IN CRITICALLY ILL PATIENTS - EXCESS LENGTH OF STAY, EXTRA COSTS, AND ATTRIBUTABLE MORTALITY
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DOI：
10.1001/jama.271.20.1598
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发表时间：
1994-05-25
影响因子：
120.7
通讯作者：
WENZEL, RP
中科院分区：
文献类型：
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作者：
PITTET, D;TARARA, D;WENZEL, RP
目的：确定危重病患者因医院血流感染引起的额外住院时间、额外费用和死亡率。设计-成对配对(1：1)病例中心研究。设置-三级卫生保健机构的外科重症监护病房(SICU)。患者-1988年7月1日至1990年6月30日期间在SICU住院的所有患者均符合条件。病例定义为医院内血流感染患者；对照按配对变量逐步选择。方法-配对变量为入院诊断、年龄、性别、病例感染前住院时间和出院诊断总数。89%的队列匹配成功；86对匹配的病例对照研究。主要结果指标：粗死亡率和归因性死亡率，住院和SICU的超长时间，以及总成本。结果：在研究期间，每100名SICU住院患者中，医院血流感染的发生率为2.67。病例组和对照组的粗死亡率分别为50%和15%(P
Objective.-To determine the excess length of stay, extra costs, and mortality attributable to nosocomial bloodstream infection in critically ill patients.Design.-Pairwise-matched (1:1) case-central study.Setting.-Surgical intensive care unit (SICU) in a tertiary health care institution.Patients.-All patients admitted in the SICU between July 1, 1988, and June 30, 1990, were eligible. Cases were defined as patients with nosocomial bloodstream infection; controls were selected according to matching variables in a stepwise fashion.Methods.-Matching variables were primary diagnosis for admission, age, sex, length of stay before the day of infection in cases, and total number of discharge diagnoses. Matching was successful for 89% of the cohort; 86 matched case-control pairs were studied.Main Outcome Measures.-Crude and attributable mortality, excess length of hospital and SICU stay, and overall costs.Results.-Nosocomial bloodstream infection complicated 2.67 per 100 admissions to the SICU during the study period. The crude mortality rates from cases and controls were 50% and 15%, respectively (P