The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive cave unit
The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive cave unit
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DOI：
10.1164/ajrccm.160.3.9808145
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发表时间：
1999-09-01
影响因子：
24.7
通讯作者：
Higgins, M
中科院分区：
文献类型：
--
作者：
DiGiovine, B;Chenoweth, C;Higgins, M
原发性医院内血流感染（BSI）是重症监护病房（ICU）中常见的疾病，其粗死亡率为31.5%至82.4%。然而，由于疾病严重程度的混杂，对归因死亡率的准确估计受到限制。我们进行了这项研究，以评估归因于死亡率和成本与BSI发作。感染患者定义为在研究期间发生BSI的患者。未感染的对照组受试者与感染的患者根据许多因素进行匹配，包括感染前一天的预测死亡率。主要的结局指标是ICU的粗死亡率、住院时间和费用。我们发现感染和未感染患者的粗死亡率无差异（分别为35.3%和30.9%，p = 0.51）。然而，在幸存者中，院内血流感染患者确实有额外的住院时间（平均值，10天;中位数，5天; p = 0.007）和增加的直接成本（平均差异，34，508美元; p = 0.008）。在匹配疾病严重程度后，我们无法检测到原发性院内血流感染与ICU死亡率增加之间的相关性。我们确实发现原发性院内血流感染增加了ICU住院时间和费用。
Primary nosocomial bloodstream infection (BSI) is a common occurrence in the intensive care unit (ICU) and is associated with a crude mortality of 31.5 to 82.4%. However, an accurate estimate of the attributable mortality has been limited because of confounding by severity of illness. We undertook this study to assess the attributable mortality and costs associated with an episode of BSI. Infected patients were defined as those who had an episode of BSI during the study period. Uninfected control subjects were matched to the infected patients based upon a number of factors, including predicted mortality on the day prior to infection. The main outcome measures were crude ICU mortality, length of stay, and costs. We found no difference in the crude mortality for the infected and the uninfected patients (35.3 and 30.9%, respectively, p = 0.51). However, among survivors, the patients with nosocomial bloodstream infections did have excess length of stay (mean, 10 d; median, 5 d; p = 0.007) and increased direct costs (mean difference, $34,508; p = 0.008). After matching for severity of illness, we could not detect an association between primary nosocomial bloodstream infections and increased ICU mortality. We did find that primary nosocomial bloodstream infections increased ICU length of stay and costs.