Cost of intensive care unit-acquired bloodstream infections
Cost of intensive care unit-acquired bloodstream infections
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DOI：
10.1016/j.jhin.2005.12.016
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发表时间：
2006-06-01
影响因子：
6.9
通讯作者：
Manns, B. J.
中科院分区：
文献类型：
--
作者：
Laupland, K. B.;Lee, H.;Manns, B. J.
重症监护病房获得性（ICU获得性）血流感染（BSI）是危重病的重要并发症。本研究的目的是量化ICU获得的BSI导致的住院时间过长、死亡率和费用。2000年5月1日至2003年4月30日，在卡尔加里卫生区的所有成人ICU中进行了一项匹配队列研究。将144例ICU获得性BSI患者与无ICU获得性BSI的患者进行匹配（1：1）。ICU获得性BSI患者的ICU住院时间中位数[15.5 [四分位距（IQR）8-26]天vs 12 [IQR 7-18.5]天，P = 0.003]和住院治疗费用中位数[85137美元（IQR $45740-131412）vs $67879（IQR $35043-115915，P = 0.02）与无ICU获得BSI的患者相比。ICU住院时间的中位数为2天，ICU获得的BSI的中位数成本为12321美元/例。60例（42%）病例死亡，对照组37例（26%）[P = 0.002，归因死亡率16%，95%置信区间（CI）5.9-26.0%]。ICU获得性BSI患者的院内死亡风险增加（比值比= 2.64，95% CI 1.40-5.29）。在存活者配对中，ICU获得的BSI导致的ICU和住院时间的中位数分别为2天和13.5天，ICU获得的BSI导致的成本为每例存活者25155美元。重症患者发生ICU获得性BSI的发病率和死亡率过高，并导致医疗保健费用显著增加。这些数据支持用于感染预防和控制方案的支出，并支持进一步研究如何减少这些感染的影响。(c)2006年，医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
Intensive care unit-acquired (ICU-acquired) bloodstream infections (BSI) are an important complication of critical illness. The objective of this study was to quantify the excess length of stay, mortality and cost attributable to ICU-acquired BSI. A matched cohort study was conducted in all adult ICUs in the Calgary Health Region between 1 May 2000 and 30 April 2003. One hundred and forty-four patients with ICU-acquired BSI were matched (1:1) to patients without ICU-acquired BSI. Patients with ICU-acquired BSI had a significantly increased median length of ICU stay [15.5 [interquartile range (IQR) 8-26] days vs 12 [IQR 7-18.5] days, P = 0.003] and median costs of hospital care [$85137 (IQR $45740-131412) vs $67879 (IQR $35043-115915, P = 0.02) compared with patients without ICU-acquired BSI. The median excess length of ICU stay was two days and the median cost attributabte to ICU-acquired BSI was $12321 per case. Sixty (42%) of the cases died compared with 37 (26%) of the controls [P = 0.002, attributable mortality 16%, 95% confidence interval (CI) 5.9-26.0%]. Patients with ICU-acquired BSI were at increased risk for in-hospital death (odds ratio = 2.64, 95% CI 1.40-5.29). Among survivor-matched pairs, the median excess lengths of ICU and hospital stay attributable to development of ICU-acquired BSI were two and 13.5 days, respectively, and the attributable cost due to ICU-acquired BSI was $25155 per case survivor. Critically ill patients who develop ICU-acquired BSI suffer excess morbidity and mortality, and incur significantly increased health-care costs. These data support expenditures on infection prevention and control programmes and further research into reducing the impact of these infections. (c) 2006 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.