Olsen Margaret A, Chu-Ongsakul Sorawuth, Brandt Keith E, Dietz Jill R, Mayfield Jennie, Fraser Victoria J
Division of Infectious Diseases, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8051, St Louis, MO 63110, USA.
Arch Surg. 2008 Jan;143(1):53-60; discussion 61. doi: 10.1001/archsurg.2007.11.
To determine the attributable costs associated with surgical site infection (SSI) following breast surgery.
Cost analysis of a retrospective cohort in a tertiary care university hospital.
All persons who underwent breast surgery other than breast-conserving surgery from July 1, 1999, through June 30, 2002.
Surgical site infection and hospital costs. Costs included all those incurred in the original surgical admission and any readmission(s) within 1 year of surgery, inflation adjusted to US dollars in 2004.
Surgical site infection was identified in 50 women during the original surgical admission or at readmission to the hospital within 1 year of surgery (N = 949). The incidence of SSI was 12.4% following mastectomy with immediate implant reconstruction, 6.2% following mastectomy with immediate reconstruction using a transverse rectus abdominis myocutaneous flap, 4.4% following mastectomy only, and 1.1% following breast reduction surgery. Of the SSI cases, 96.0% were identified at readmission to the hospital. Patients with SSI had crude median costs of $16 882 compared with $6123 for uninfected patients. After adjusting for the type of surgical procedure(s), breast cancer stage, and other variables associated with significantly increased costs using feasible generalized least squares, the attributable cost of SSI after breast surgery was $4091 (95% confidence interval, $2839-$5533).
Surgical site infection after breast cancer surgical procedures was more common than expected for clean surgery and more common than SSI after non-cancer-related breast surgical procedures. Knowledge of the attributable costs of SSI in this patient population can be used to justify infection control interventions to reduce the risk of infection.
确定乳房手术后手术部位感染（SSI）所产生的可归因成本。
对一家三级护理大学医院的回顾性队列进行成本分析。
1999年7月1日至2002年6月30日期间接受除保乳手术之外的乳房手术的所有患者。
手术部位感染和医院成本。成本包括初次手术入院期间以及术后1年内再次入院所产生的所有费用，并按2004年美元进行通胀调整。
在初次手术入院期间或术后1年内再次入院时，949例患者中有50例被确诊发生手术部位感染。乳房切除并即刻植入重建术后SSI发生率为12.4%，乳房切除并即刻采用腹直肌肌皮瓣重建术后为6.2%，单纯乳房切除术后为4.4%，乳房缩小术后为1.1%。在发生SSI的病例中，96.0%是在再次入院时确诊的。发生SSI的患者粗略中位成本为16,882美元，而未感染患者为6123美元。在使用可行广义最小二乘法对手术类型、乳腺癌分期以及其他与成本显著增加相关的变量进行校正后，乳房手术后SSI的可归因成本为4091美元（95%置信区间为2839 - 5533美元）。
乳腺癌手术操作后的手术部位感染比清洁手术预期的更常见，且比非癌症相关乳房手术操作后的SSI更常见。了解该患者群体中SSI的可归因成本可用于证明感染控制干预措施的合理性，以降低感染风险。
