Healthcare resources attributable to methicillin-resistant Staphylococcus aureus orthopedic surgical site infections.
Healthcare resources attributable to methicillin-resistant Staphylococcus aureus orthopedic surgical site infections.
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DOI：
10.1038/s41598-020-74070-4
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发表时间：
2020-10-13
影响因子：
4.6
通讯作者：
Matsushita K
中科院分区：
文献类型：
--
作者：
Fukuda H;Sato D;Iwamoto T;Yamada K;Matsushita K
随着人口的稳步老龄化，骨科手术的数量正在增加，但手术部位感染（SSI）率仍然相对稳定。本研究旨在量化骨科手术患者中耐甲氧西林金黄色葡萄球菌（MRSA）SSI的医疗资源。这项分析是使用一个全国索赔数据库进行的，该数据库包括几乎所有日本居民的数据。我们检查了2012年4月至2018年3月期间接受以下任何手术的患者：截肢（AMP）、脊柱融合（FUSN）、骨折开放复位（FX）、髋关节假体（HPRO）、膝关节假体（KPRO）和椎板切除术（LAM）。进行倾向评分匹配以识别非SSI对照患者，并使用广义估计方程估计病例组和对照组之间的结局差异。MRSA SSI病例数（感染率）范围为64例（0.03%）至1，152例（2.33%）。MRSA SSI导致的医疗支出增加范围从LAM的11，630美元（21，151美元对9，521美元）到FX的35，693美元（50，122美元对14，429美元），住院时间增加范围从LAM的40.6天（59.2对18.6）到FX的89.5天（122.0对32.5）。总之，MRSA SSI有助于医疗资源利用的大幅增加，强调需要实施有效的骨科手术感染预防措施。
The number of orthopedic surgeries is increasing as populations steadily age, but surgical site infection (SSI) rates remain relatively consistent. This study aimed to quantify the healthcare resources attributable to methicillin-resistant Staphylococcus aureus (MRSA) SSIs in orthopedic surgical patients. The analysis was conducted using a national claims database comprising data from almost all Japanese residents. We examined patients who underwent any of the following surgeries between April 2012 and March 2018: amputation (AMP), spinal fusion (FUSN), open reduction of fracture (FX), hip prosthesis (HPRO), knee prosthesis (KPRO), and laminectomy (LAM). Propensity score matching was performed to identify non-SSI control patients, and generalized estimating equations were used to estimate the differences in outcomes between the case and control groups. The numbers of MRSA SSI cases (infection rates) ranged from 64 (0.03%) to 1,152 (2.33%). MRSA SSI-attributable increases in healthcare expenditure ranged from $11,630 ($21,151 vs. $9,521) for LAM to $35,693 ($50,122 vs. $14,429) for FX, and increases in hospital stay ranged from 40.6 days (59.2 vs. 18.6) for LAM to 89.5 days (122.0 vs. 32.5) for FX. In conclusion, MRSA SSIs contribute to substantial increases in healthcare resource utilization, emphasizing the need to implement effective infection prevention measures for orthopedic surgeries.
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