Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: attributable costs and outcomes
Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: attributable costs and outcomes
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DOI：
10.1007/s00134-002-1276-8
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发表时间：
2002-06-01
影响因子：
38.9
通讯作者：
Hendrix, CW
中科院分区：
文献类型：
--
作者：
Pelz, RK;Lipsett, PA;Hendrix, CW
目的：确定与万古霉素耐药肠球菌（VRE）感染相关的经济和临床结局，并将这些结局与万古霉素敏感肠球菌（VSE）感染相关的结局进行比较。对117名高危人群进行前瞻性队列研究。我们收集了所有危重患者在ICU期间的完整临床和人口统计学数据以及ICU费用数据。在对逐步多元回归模型中的变量进行调整后，VRE感染与每位患者ICU费用增加的中位数（33，251美元）相关（38.088欧元）和住院时间（LOS）增加22天，而VSE感染与21，914美元（25，102欧元）的费用增加和27天的LOS增加有关。VRE和VSE感染的效果没有显著差异，在整个队列中，与VRE感染相关的ICU患者日的归因成本为$304（348欧元）。结论：与VRE感染相关的ICU护理的归因成本为$33，25 1（38，088欧元），ICU患者日的归因成本为$304（348欧元）。VRE和VSE感染在ICU护理相关费用、LOS或死亡率方面没有差异。任何VRE控制策略都是具有成本效益的，如果ICU患者日的总成本低于304美元（348欧元）。
Objectives: To determine the economic and clinical outcomes associated with infection with vancomycin-resistant Enterococcus (VRE) and to compare these outcomes to those associated with infection with vancomycin-sensitive Enterococcus (VSE).Methods: During a 3-month. prospective, cohort study of 117 high-risk. critically ill patients we collected complete clinical and demographic and ICU cost data from all patients during their ICU stays.Results: After adjusting for variables in a stepwise multiple regression model VRE infections were associated with a median attributable increased ICU cost per patient of $33,251 (38.088 euros) and an increased length of hospital stay (LOS) of 22 days, while VSE infections were associated with an increased cost of $21,914 (25,102 euros) and an increased LOS of 27 days. The effect of VRE and VSE infections were not significantly different, Over the entire cohort the attributable cost per ICU patient day associated with VRE infection was $304 (348 euros).Conclusions: The attributable cost of ICU care associated with VRE infection is $33,25 1 (38,088 euros) and per ICU patient day was $304 (348 euros). VRE and VSE infections do not differ in associated cost of ICU care, LOS, or mortality. Any VRE control strategy is be cost-effective if the overall cost per ICU patient-day is less than $304 (348 euros).