The attributable cost, length of hospital stay, and mortality of central line-associated bloodstream infection in intensive care departments in Argentina: A prospective, matched analysis

被引:156
作者
Rosenthal, VD
Guzman, S
Migone, O
Crnich, CJ
机构
[1] Hosp Epidemiol Inc, RA-1405 Buenos Aires, DF, Argentina
[2] Bernal Med Ctr, Colegiales Med Ctr, Dept Infect Dis, Buenos Aires, DF, Argentina
[3] Bernal Med Ctr, Dept Finance, Buenos Aires, DF, Argentina
[4] Univ Wisconsin, Sch Med, Dept Med, Infect Dis Sect, Madison, WI USA
关键词
D O I
10.1016/j.ajic.2003.03.002
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Limited information is available on the financial impact of central venous catheter-associated bloodstream infection (BSI) in Argentina. To calculate the cost of BSIs in the intensive care department (ICU), a 5-year prospective nested case-control study was undertaken at 3 hospitals in Argentina. Methods: We studied 6 adult ICUs from 3 hospitals. In all, 142 patients with BSI and 142 control patients without BSI were matched for hospital, type of ICU, year of admission, length of stay, sex, age, and average severity of illness score. Patients' length of stay in the ICU was obtained prospectively on daily rounds. The hospitals' finance departments provided the cost of each ICU day. The hospitals' pharmacies provided the cost of antibiotics prescribed for BSIs. Results: The mean extra length of stay for patients with BSI compared with control patients was 11.9 days, the mean extra antibiotic defined daily dose was 22.6, the mean extra antibiotic cost was $1913, the mean extra cost was $4888.42, and the excess mortality was 24.6%. Conclusions: In this study, patients with central venous catheter-associated BSI experienced significant prolongation of hospitalization. increased use of health care costs, and a higher attributable mortality. These findings support the need to implement preventative interventions for patients hospitalized with central venous catheters in Argentina.
引用
收藏
页码:475 / 480
页数:6
相关论文
共 42 条
[1]   CONSEQUENCES OF INTRAVASCULAR CATHETER SEPSIS [J].
ARNOW, PM ;
QUIMOSING, EM ;
BEACH, M .
CLINICAL INFECTIOUS DISEASES, 1993, 16 (06) :778-784
[2]   INTRAVASCULAR CATHETER-ASSOCIATED SEPSIS - A COMMON PROBLEM [J].
COLLIGNON, PJ .
MEDICAL JOURNAL OF AUSTRALIA, 1994, 161 (06) :374-378
[3]   The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices [J].
Crnich, CJ ;
Maki, DG .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (09) :1232-1242
[4]   The promise of novel technology for the prevention of intravascular device-related bloodstream infection. II. Long-term devices [J].
Crnich, CJ ;
Maki, DG .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (10) :1362-1368
[5]  
Crnich CJ, 2002, J CRIT ILLNESS, V17, P48
[6]   The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive cave unit [J].
DiGiovine, B ;
Chenoweth, C ;
Watts, C ;
Higgins, M .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 160 (03) :976-981
[7]   Increased resource use associated with catheter-related bloodstream infection in the surgical intensive care unit [J].
Dimick, JB ;
Pelz, RK ;
Consunji, R ;
Swoboda, SM ;
Hendrix, CW ;
Lipsett, PA .
ARCHIVES OF SURGERY, 2001, 136 (02) :229-234
[8]   CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].
GARNER, JS ;
JARVIS, WR ;
EMORI, TG ;
HORAN, TC ;
HUGHES, JM .
AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140
[9]   THE NATIONAL NOSOCOMIAL INFECTIONS SURVEILLANCE SYSTEM - PLANS FOR THE 1990S AND BEYOND [J].
GAYNES, RP ;
CULVER, DH ;
EMORI, TG ;
HORAN, TC ;
BANERJEE, SN ;
EDWARDS, JR ;
JARVIS, WR ;
TOLSON, JS ;
HENDERSON, TS ;
HUGHES, JM ;
MARTONE, WJ .
AMERICAN JOURNAL OF MEDICINE, 1991, 91 :S116-S120
[10]   Central venous catheter-related bloodstream infections: an analysis of incidence and risk factors in a cohort of 400 patients [J].
Gowardman, JR ;
Montgomery, C ;
Thirlwell, S ;
Shewan, S ;
Idema, A ;
Larsen, PD ;
Havill, JH .
INTENSIVE CARE MEDICINE, 1998, 24 (10) :1034-1039