Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients.
Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients.
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DOI：
10.1001/archsurg.2011.41
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发表时间：
2011-07
影响因子：
--
通讯作者：
Dick, Andrew W.
中科院分区：
文献类型：
--
作者：
Glance, Laurent G.;Stone, Pat W.;Mukamel, Dana B.;Dick, Andrew W.
使用全国代表性数据库探索创伤患者医院获得性感染（HAI）的临床影响和经济负担。回顾性研究。医疗保健成本和利用项目全国住院患者样本。创伤病人。我们使用logistic回归和广义线性模型研究了HAI（败血症、肺炎、葡萄球菌感染和艰难梭菌相关疾病）与住院死亡率、住院时间和住院费用之间的关系。在控制了患者人口统计学、损伤机制、损伤类型、损伤严重程度和合并症后，我们发现HAI患者的死亡率、费用和住院时间显著高于无HAI患者。脓毒症患者的死亡率是无HAI患者的近6倍（比值比，5.78; 95%可信区间，5.03-6.64; P <0.001）。其他HAI患者的死亡率比对照组高1.5- 1.9倍（P <0.005）。HAI患者的费用比无HAI患者高约2- 2.5倍（P <0.001）。HAI患者的中位住院时间大约是无HAI患者的2倍（P <0.001）。患有HAI的创伤患者死亡风险增加，住院时间更长，住院费用更高。鉴于许多HAI的可预防性以及与HAI相关的临床和经济负担的程度，旨在降低HAI发生率的政策可能对受伤患者的结局产生潜在的巨大影响。
To explore the clinical impact and economic burden of hospital-acquired infections (HAIs) in trauma patients using a nationally representative database. Retrospective study. The Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Trauma patients. We examined the association between HAIs (sepsis, pneumonia, Staphylococcus infections, and Clostridium difficile–associated disease) and in-hospital mortality, length of stay, and inpatient costs using logistic regression and generalized linear models. After controlling for patient demographics, mechanism of injury, injury type, injury severity, and comorbidities, we found that mortality, cost, and length of stay were significantly higher in patients with HAIs compared with patients without HAIs. Patients with sepsis had a nearly 6-fold higher odds of death compared with patients without an HAI (odds ratio, 5.78; 95% confidence interval, 5.03–6.64; P < .001). Patients with other HAIs had a 1.5- to1.9-fold higher odds of mortality compared with controls (P < .005). Patients with HAIs had costs that were approximately 2- to 2.5-fold higher compared with patients without HAIs (P < .001). The median length of stay was approximately 2-fold higher in patients with HAIs compared with patients without HAIs (P < .001). Trauma patients with HAIs are at increased risk for mortality, have longer lengths of stay, and incur higher inpatient costs. In light of the preventability of many HAIs and the magnitude of the clinical and economic burden associated with HAIs, policies aiming to decrease the incidence of HAIs may have a potentially large impact on outcomes in injured patients.
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影响因子：
9
作者：
Glance, Laurent G.;Dick, Andrew W.;Osler, Turner M.
通讯作者：
Osler, Turner M.
DOI：
10.1016/s0020-1383(00)00103-0
发表时间：
2001-01-01
影响因子：
2.5
作者：
Flores, JM;Jiménez, PI;Murillo, F
通讯作者：
Murillo, F
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
8.8
作者：
Cavalcanti, M;Ferrer, M;Torres, A
通讯作者：
Torres, A
影响因子：
--
作者：
Eber, Michael R.;Laxminarayan, Ramanan;Malani, Anup
通讯作者：
Malani, Anup