Surgical site infection: Incidence and impact on hospital utilization and treatment costs
Surgical site infection: Incidence and impact on hospital utilization and treatment costs
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DOI：
10.1016/j.ajic.2008.12.010
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发表时间：
2009-06-01
影响因子：
4.9
通讯作者：
Vaughn, Brian B.
中科院分区：
文献类型：
--
作者：
de Lissovoy, Gregory;Fraeman, Kathy;Vaughn, Brian B.
背景资料：手术部位感染（SSI）是严重的手术并发症，发生在约2%的外科手术中，约占20%的医疗保健相关感染。方法：SSI是根据ICD-9-CM诊断代码998.59在7类外科手术出院记录中的存在而确定的：神经系统：心血管结直肠皮肤、皮下组织和乳房：胃肠道;整形外科;妇产科。数据来源是2005年医疗保健成本和利用项目国家住院病人样本（HCUP NIS）。主要研究结果是手术类别的SSI发生率以及SSI对住院时间和费用的影响。结果：在样本中的723，490例外科住院中，确定了6891例SSI（1%）。平均而言，SSI将住院时间延长了9.7天，而每次住院的费用增加了20，842美元。从国家的角度来看，这些SSI病例与额外的406，730个住院日和超过9亿美元的住院费用有关。另外91，613例因SSI治疗而再次入院的患者又增加了521，933天的护理时间，费用接近7亿美元。结论：就住院时间延长和治疗费用增加而言，SSI会带来重大的经济负担。我们的分析记录了近100万个额外的住院日和16亿美元的额外费用。版权所有（C）2009年由感染控制和流行病学专业人员协会，公司。(Am J Infect Control 2009;37387-97.）
Background: Surgical site infections (SSIs) are serious operative complications that occur in approximately 2% of surgical procedures and account for some 20% of health care-associated infections.Methods: SSI was identified based on the presence of ICD-9-CM diagnosis code 998.59 in hospital discharge records for 7 categories of surgical procedures: neurological: cardiovascular colorectal skin, subcutaneous tissue, and breast: gastrointestinal; orthopedic: and obstetric and gynecologic. Source of data was the 2005 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP NIS). Primary study outcomes were rate of SSI by surgical category and impact of SSI on length of stay and cost.Results were projected to the national level. Results: Among 723,490 surgical hospitalizations in the sample, 6891 cases of SSI were identified (1%). On average, SSI extended length of stay by 9.7 days while increasing cost by $20,842 per admission. From the national perspective, these cases of SSI were associated with an additional 406,730 hospital-days and hospital costs exceeding $900 million. An additional 91,613 readmissions for treatment of SSI accounted for a further 521,933 days of care at a cost of nearly $700 million.Conclusion: SSI is associated with a significant economic burden in terms of extended length of stay and increased costs of treatment. Our analysis documented nearly I million additional inpatient-days and $1.6 billion in excess costs. Copyright (C) 2009 by the Association for Professionals in Infection Control and Epidemiology, Inc. (Am J Infect Control 2009;37387-97.)