Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort.
Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort.
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DOI：
10.1086/649020
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发表时间：
2010-01
影响因子：
4.5
通讯作者：
Fraser VJ
中科院分区：
文献类型：
--
作者：
Butler AM;Olsen MA;Merz LR;Guth RM;Woeltje KF;Camins BC;Fraser VJ
万古霉素耐药肠球菌（VRE）血流感染（BSI）与发病率和死亡率增加有关。确定万古霉素敏感（VSE）和VRE BSI的可归因成本以及万古霉素耐药对医院成本的独立影响。对2002年至2003年期间在一个学术医学中心住院的21,154名非手术患者进行了一项回顾性队列研究。使用行政数据，归因于医院成本（通货膨胀调整到2007美元）和住院时间估计与多变量广义最小二乘（GLS）模型和倾向评分匹配对。该队列包括182例VSE和94例VRE BSI病例。在对人口统计学、合并症、手术、非肠球菌性BSI和早期死亡率进行调整后，VSE BSI的可归因成本为2，250美元（95%置信区间[CI]，$1，758-$2，880）和$2，023（95% CI，1，588 - 2，575美元），VRE BSI的可归因成本为4，479美元（95% CI，$3，500-$5，732），在倾向评分加权GLS模型中为$4，036（95% CI，$3，170-$5，140）。VSE BSI和VRE BSI的配对成本差异中位数分别为5，282美元（2，042 - 8，043美元）和9，949美元（95% CI，1，579 - 24，693美元）。标准GLS模型中万古霉素耐药的可归因成本为1，713美元（95%CI，1，338 - 2，192美元），倾向评分加权GLS模型中为1，546美元（95%CI，1，214 - 1，968美元）。VSE BSI病例的归因住院时间范围为1.1-2.2天，VRE BSI病例为2.2-3.5天。VSE和VRE BSI与住院费用和住院时间独立相关。万古霉素耐药与费用增加有关。
Vancomycin-resistant enterococcal (VRE) bloodstream infections (BSI) are associated with increased morbidity and mortality. To determine the attributable costs of vancomycin-sensitive (VSE) and VRE BSI and the independent impact of vancomycin-resistance on hospital costs. A retrospective cohort study was conducted of 21,154 non-surgical patients admitted to an academic medical center between 2002 and 2003. Using administrative data, attributable hospital costs (inflation adjusted to $2007) and length of stay were estimated with multivariate generalized least squares (GLS) models and propensity score matched-pairs. The cohort included 182 VSE and 94 VRE BSI cases. After adjustment for demographics, comorbidities, procedures, non-enterococcal BSI, and early mortality, the attributable costs of VSE BSI were $2,250 (95% confidence interval [CI], $1,758–$2,880) in the standard GLS model and $2,023 (95% CI, $1,588–$2,575) in the propensity-score weighted GLS model and the attributable costs of VRE BSI were $4,479 (95% CI, $3,500–$5,732) in the standard GLS model and $4,036 (95% CI, $3,170–$5,140) in the propensity-score weighted GLS model. The median of the difference in costs between matched-pairs was $5,282 ($2,042–$8,043) for VSE BSI and $9,949 (95% CI, $1,579–$24,693) for VRE BSI. The attributable costs of vancomycin-resistance were $1,713 (95% CI, $1,338–$2,192) in the standard GLS model and $1,546 (95% CI, $1,214–$1,968) in the propensity-score weighted GLS model. Attributable length of stay ranged from 1.1–2.2 days for VSE BSI and 2.2–3.5 days for VRE BSI cases. VSE and VRE BSI were independently associated with hospital costs and length of stay. Vancomycin-resistance was associated with increased costs.
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影响因子：
39.2
作者：
Vergis, EN;Hayden, MK;Muder, RR
通讯作者：
Muder, RR
影响因子：
11.8
作者：
Linden, PK;Pasculle, AW;Kusne, S
通讯作者：
Kusne, S
影响因子：
38.9
作者：
Pelz, RK;Lipsett, PA;Hendrix, CW
通讯作者：
Hendrix, CW
影响因子：
4.5
作者：
Salgado, CD;Farr, BM
通讯作者：
Farr, BM
影响因子：
7.2
作者：
Newschaffer, CJ;Bush, TL;Penberthy, LT
通讯作者：
Penberthy, LT