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阿根廷重症监护病房中心静脉导管相关血流感染的归因成本、住院时间和死亡率:一项前瞻性配对分析。

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.

作者信息

Rosenthal Victor Daniel, Guzman Sandra, Migone Oscar, Crnich Christopher J

机构信息

Bernal Medical Center, Colegiales Medical Center, Department of Infectious Diseases, and Hospital Epidemiology, Buenos Aires, Argentina.

出版信息

Am J Infect Control. 2003 Dec;31(8):475-80. doi: 10.1016/j.ajic.2003.03.002.

DOI:10.1016/j.ajic.2003.03.002
PMID:14647110
Abstract

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.

摘要

背景

关于阿根廷中心静脉导管相关血流感染(BSI)的经济影响的信息有限。为了计算重症监护病房(ICU)中BSI的成本,在阿根廷的3家医院进行了一项为期5年的前瞻性巢式病例对照研究。

方法

我们研究了来自3家医院的6个成人ICU。总共142例BSI患者和142例无BSI的对照患者按医院、ICU类型、入院年份、住院时间、性别、年龄和疾病严重程度平均评分进行匹配。患者在ICU的住院时间是通过每日查房前瞻性获得的。医院财务部门提供每个ICU日的成本。医院药房提供为BSI开具的抗生素成本。

结果

与对照患者相比,BSI患者的平均额外住院时间为11.9天,平均额外抗生素限定日剂量为22.6,平均额外抗生素成本为1913美元,平均额外成本为4888.42美元,额外死亡率为24.6%。

结论

在本研究中,中心静脉导管相关BSI患者的住院时间显著延长,医疗保健成本使用增加,归因死亡率更高。这些发现支持在阿根廷对使用中心静脉导管住院的患者实施预防干预措施的必要性。

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