Verlängerung der Krankenhausverweildauer durch nosokomiale Pneumonie und Wundinfektion

Abstract

From June 1988 to September 1989, a prospective survey comprising a total of 1183 patients in a university hospital was carried out to ascertain the additional length of stay in intensive care units because of nosocomial pneumonia associated with artificial ventilation (418 patients, 296 men, 122 women, mean age 48.8 +/- 21 years, ventilated for more than 24 h) or by postoperative wound infections (765 patients, 501 men, 264 women, mean age 60 +/- 11 years, after operations on the large bowel, heart or biliary tract). Each patient with a nosocomial infection was matched against a variable number of control patients (for cases of pneumonia a maximum of 6, for wound infections a maximum of 10) without nosocomial infection. Pneumonia developed in 100 (23.9%) of artificially ventilated patients, and 46 of these patients together with 101 controls were entered into the matching procedure. 24 patients with pneumonia had to be excluded from analysis because no controls could be found for them, and also 30 patients who died while in the intensive care unit. 49 (6.4%) of the surgical patients contracted postoperative wound infections. 43 of them, together with 210 controls, were entered into the matching procedure. Among patients with pneumonia the average additional duration of stay was 11.5 days, and among patients with post-operative wound infections it was 13.9 days. The results confirm that nosocomial infections contribute substantially to prolongation of hospital stay and hence to the costs.

Perioperative Antibiotikatherapie in der Thoraxchirurgie

“…Inzidenz und Risikofaktoren in der Thoraxchirurgie ! Die nosokomiale Pneumonie zählt zu den häufigsten nosokomialen Infektionen und führt aufgrund der einhergehenden höheren Morbidität und Letalität zu einer verlängerten Krankenhausverweildauer [32]. Die POP ist eine häufige und schwerwiegende Komplikation nach größeren thoraxchirurgischen Operationen, die unterschiedliche Ursachen haben kann (z.…”

Wundinfektionen in der Viszeralchirurgie - Ätiologie, Risikofaktoren, Antibiotikaprophylaxe

“…Für abdominalchirurgische Eingriffe bedeutet dies eine Zunahme der Verweildauer nach Cholezystektomie um 4,4 Tage, nach Kolonchirurgie um 19 Tage. Dies bedeutet eine Verlängerung der mittleren Verweildauer um 3,9 Tage [30]. Insgesamt kumulieren die zusätzlichen Verweiltage in Deutschland auf 1 Mio.…”