Penel N, Lefebvre J-L, Cazin J L, Clisant S, Neu J-C, Dervaux B, Yazdanpanah Y
Département de Cancérologie Générale, Centre Oscar Lambret, Lille, France.
Int J Oral Maxillofac Surg. 2008 Feb;37(2):135-9. doi: 10.1016/j.ijom.2007.08.002. Epub 2007 Nov 19.
The clinical impact of surgical site infections (SSI) and postoperative pneumonia (PP) after head and neck cancer surgery has been assessed in the past, but little is known about their economic impact. The present study was designed to evaluate costs related to SSI and PP after head and neck cancer surgery with opening of mucosa. The incidence of SSI and PP was measured in a prospective cohort of 261 patients who had undergone head and neck cancer surgery. The additional direct medical costs related to these infections from the hospital perspective were determined based on postoperative length of stay. The mean direct hospital costs for patients with and without SSI or PP were compared. Of the 261 patients, 81 (31%), 21 (8%) and 13 (5%) developed SSI, PP or both, respectively. The additional lengths of stay attributable to SSI, PP or both were 16, 17 and 31 days, respectively, and additional direct medical costs related to these conditions were 17,000, 19,000 and 35,000 Euros. Nosocomial infections after head and neck cancer surgery significantly increase patients' length of stay and therefore generate additional direct medical costs. These results support the application of preventive interventions to reduce nosocomial infections in this setting.
过去已评估过头颈癌手术后手术部位感染（SSI）和术后肺炎（PP）的临床影响，但对其经济影响知之甚少。本研究旨在评估头颈癌手术开放黏膜后与SSI和PP相关的成本。在一个由261例接受过头颈癌手术的患者组成的前瞻性队列中测量SSI和PP的发生率。从医院角度出发，根据术后住院时间确定与这些感染相关的额外直接医疗成本。比较了发生和未发生SSI或PP的患者的平均直接住院费用。在这261例患者中，分别有81例（31%）、21例（8%）和13例（5%）发生了SSI、PP或两者都发生。因SSI、PP或两者导致的额外住院时间分别为16天、17天和31天，与这些情况相关的额外直接医疗成本分别为17000欧元、19000欧元和35000欧元。头颈癌手术后的医院感染显著增加了患者的住院时间，因此产生了额外的直接医疗成本。这些结果支持在此情况下应用预防性干预措施以减少医院感染。
