Length of stay and charges associated with health care-acquired bloodstream infections

AL-Rawajfah, Omar M.; Hewitt, Jeanne Beauchamp; Stetzer, Frank; Cheema, Jehanzeb

doi:10.1016/j.ajic.2011.03.014

Cited by 40 publications

(18 citation statements)

References 34 publications

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“…Economic evaluations of CLABSI have generated estimates that vary widely, depending on the definition of the infection, outcome variable, and study design [5][6][7][8][9][10][11]. Most published studies documenting the cost of CLABSI have not distinguished fixed from variable costs.…”

Section: Introductionmentioning

confidence: 99%

Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections

Stevens

Geiger

Concannon

et al. 2014

Clinical Microbiology and Infection

145

105

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Previous work has suggested that central-line-associated bloodstream infection (CLABSI) is associated with increased costs and risk of mortality; however, no studies have looked at both total and variable costs, and information on outcomes outside of the intensive-care unit (ICU) is sparse. The aim of this study was to determine the excess in-hospital mortality and costs attributable to CLABSI in ICU and non-ICU patients. We conducted a retrospective cohort and cost-of-illness study from the hospital perspective of 398 patients at a tertiary-care academic medical centre from 1 January 2008 to 31 December 2010. All CLABSI patients and a simple random sample drawn from a list of all central lines inserted during the study period were included. Generalized linear models with log link and gamma distribution were used to model costs as a function of CLABSI and important covariates. Costs were adjusted to 2010 US dollars by use of the personal consumption expenditures for medical care index. We used multivariable logistic regression to identify independent predictors of in-hospital mortality. Among both ICU and non-ICU patients, adjusted variable costs for patients with CLABSI were c. $32 000 (2010 US dollars) higher on average than for patients without CLABSI. After we controlled for severity of illness and other healthcare-associated infections, CLABSI was associated with a 2.27-fold (95% CI 1.15-4.46) increased risk of mortality. Other healthcare-associated infections were also significantly associated with greater costs and mortality. Overall, CLABSI was associated with significantly higher adjusted in-hospital mortality and total and variable costs than those for patients without CLABSI.

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Section: Introductionmentioning

confidence: 99%

Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections

Stevens

Geiger

Concannon

et al. 2014

Clinical Microbiology and Infection

145

105

View full text Add to dashboard Cite

show abstract

“…This produces similar estimates to multistate modelling although with less precision and wider confidence intervals. [3] A combination of these two methods was used by Barnett et al who applied multistateNational Inpatient Sample (NIS) [31,35,56,57,65,71,115,119]. These studies use ICD codes to identify cases but NIS data do not provide information on the timing of infection forcing researchers to use time-fixed methods to estimate impact of HAI on LOS.…”

mentioning

confidence: 99%

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Manoukian

Stewart

Dancer

et al. 2018

Journal of Hospital Infection

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“…H ospital-acquired infections are a significant cause of patient morbidity and hospital cost in our health care system [1][2][3]. Factors that increase the risk of hospitalacquired infections, in particular catheter-associated urinary tract infections (CAUTIs), have been well documented in medical patients and in many types of surgical patients.…”

mentioning

confidence: 99%

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

Gillen

Isbell

Michaels

et al. 2015

Surgical Infections

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Background: Risk factors for catheter-associated urinary tract infections (CAUTIs) in patients undergoing noncardiac surgical procedures have been well documented. However, the variables associated with CAUTIs in the cardiac surgical population have not been clearly defined. Therefore, the purpose of this study was to investigate risk factors associated with CAUTIs in patients undergoing cardiac procedures. Methods: All patients undergoing cardiac surgery at a single institution from 2006 through 2012 (4,883 patients) were reviewed. Patients with U.S. Centers for Disease Control (CDC) criteria for CAUTI were identified from the hospital's Quality Assessment database. Pre-operative, operative, and post-operative patient factors were evaluated. Univariate and multivariable analyses were used to identify significant correlations between perioperative characteristics and CAUTIs. Results: There were 55 (1.1%) documented CAUTIs in the study population. On univariate analysis, older age, female gender, diabetes mellitus, cardiogenic shock, urgent or emergent operation, packed red blood cell (PRBC) units transfused, and intensive care unit length of stay (ICU LOS) were all significantly associated with CAUTI [p < 0.05]. On multivariable logistic regression, older age, female gender, diabetes mellitus, and ICU LOS remained significantly associated with CAUTI. Additionally, there was a significant association between CAUTI and 30-d mortality on univariate analysis. However, when controlling for common predictors of operative mortality on multivariable analysis, CAUTI was no longer associated with mortality. Conclusions: There are several identifiable risk factors for CAUTI in patients undergoing cardiac procedures. CAUTI is not independently associated with increased mortality, but it does serve as a marker of sicker patients more likely to die from other comorbidities or complications. Therefore, awareness of the high-risk nature of these patients should lead to increased diligence and may help to improve peri-operative outcomes. Recognizing patients at high risk for CAUTI may lead to improved measures to decrease CAUTI rates within this population.

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Length of stay and charges associated with health care-acquired bloodstream infections

Cited by 40 publications

References 34 publications

Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections

Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

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