The impact of carbapenem-resistant Pseudomonas aeruginosa on clinical and economic outcomes in a Chinese tertiary care hospital: A propensity score-matched analysis
The impact of carbapenem-resistant Pseudomonas aeruginosa on clinical and economic outcomes in a Chinese tertiary care hospital: A propensity score-matched analysis
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DOI：
10.1016/j.ajic.2018.10.025
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发表时间：
2019-06-01
影响因子：
4.9
通讯作者：
Chen, Yangfang
中科院分区：
文献类型：
--
作者：
Chen, Zhihui;Xu, Ziqin;Chen, Yangfang
背景资料：本研究旨在评估碳青霉烯类耐药铜绿假单胞菌（CRPA）对中国三级医疗hospital.Methods的临床和经济结局的影响：患者被分配到一个碳青霉烯类敏感的铜绿假单胞菌组或CRPA组，并匹配使用倾向评分匹配。比较两组患者的住院死亡率、住院时间、培养后住院时间、住院总费用、每日住院费用和30 d再入院率。进行亚组分析，以确定CRPA分离株患者的亚组因素和住院死亡率之间的相关性。（12.6% vs 7.8%; P = .044），LOS（中位数29.0 vs 25.5天; P = 0.026），培养后LOS（中位数18.5 vs 14.0天; P = 0.029），总住院费用（中位数6，082.0美元vs 4，9542美元; P = .015），以及每日住院费用CRPA患者中的平均治疗费用（中位数236.1美元vs 223.6美元; P = 0.045）显著高于碳青霉烯类药物敏感的铜绿假单胞菌患者。亚组分析显示CRPA与年龄之间存在显著的相互作用（P = .009）。结论：预防和控制CRPA在住院患者中，特别是在65岁以上的患者中，是降低CRPA感染或定植导致的死亡率和医疗费用的良好措施。(C)2018感染控制和流行病学专业人员协会，Inc.爱思唯尔公司出版All rights reserved.
Background: This study aimed to estimate the impact of carbapenem-resistant Pseudomonas aeruginosa (CRPA) on clinical and economic outcomes in a Chinese tertiary care hospital.Methods: Patients were assigned to a carbapenem-susceptible P aeruginosa group or to a CRPA group and matched using propensity score matching. In-hospital mortality, length of stay (LOS), LOS after culture, total hospital costs, daily hospital cost, and 30-day readmission were comparatively analyzed. Subgroup analysis was performed to determine the associations between the subgrouping factors and in-hospital mortality in patients with CRPA isolates.Results: Within the propensity-matched cohort, in-hospital mortality (12.6% vs 7.8%; P = .044), LOS (median 29.0 vs 25.5 days; P = .026), LOS after culture (median 18.5 vs 14.0 days; P = .029), total hospital costs (median $6,082.0 vs $4,9542; P = .015), and daily hospital cost (median $236.1 vs $223.6; P = .045) were significantly higher in CRPA patients than in carbapenem-susceptible P aeruginosa patients. Subgroup analysis revealed a significant interaction between CRPA and age (P = .009).Conclusion: Prevention and control of CRPA among hospitalized patients, especially among those over the age of 65 years, is a good measurement for the reduction of mortality and medical costs derived from CRPA infection or colonization. (C) 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.