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日本结直肠手术后手术部位感染对住院时间和医疗支出的影响。

Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan.

机构信息

Department of Surgery, Teine Keijinkai Hospital, 1-12 Maeda Teine-ku, Sapporo 006-8555, Japan.

出版信息

Surg Today. 2012 Jul;42(7):639-45. doi: 10.1007/s00595-012-0126-8.

Abstract

PURPOSE

To clarify the impact of surgical site infection (SSI) after colorectal surgery on the length of hospital stay and medical expenditure in Japan.

METHODS

This was a multi-center, retrospective-matched case-control study.

RESULTS

The total number of patients enrolled was 334 (167 case/control pairs). The average hospital stay after surgery was prolonged by 17.8 days (95% CI 11.9-23.5) and the average medical cost after surgery was increased by $5,938 (95% CI 3,610-8,367) in the SSI group versus the non-SSI group. Hospital charges comprised the largest among all cost categories and accounted for 53% of the additional cost. The hospital stay and medical costs both increased proportionately to the depth of the SSI, from 4.4 days and $608 for superficial incisional SSI, to 39.2 days and $14,448 for organ/space SSI. SSI caused by MRSA prolonged the hospital stay by 19.3 days and incurred an additional cost of $7,015.

CONCLUSIONS

SSI clearly prolonged the hospital stay and increased medical costs. The numerical values revealed by this study reinforce the medical-economic importance of instigating preventive measures against SSI.

摘要

目的

阐明日本结直肠手术后手术部位感染(SSI)对住院时间和医疗支出的影响。

方法

这是一项多中心、回顾性配对病例对照研究。

结果

共纳入 334 名患者(167 例病例/对照)。SSI 组术后平均住院时间延长 17.8 天(95%CI 11.9-23.5),术后平均医疗费用增加 5938 美元(95%CI 3610-8367)。在所有费用类别中,住院费用占比最大,占额外费用的 53%。住院时间和医疗费用均与 SSI 的严重程度成正比,从浅表切口 SSI 的 4.4 天和 608 美元,到器官/间隙 SSI 的 39.2 天和 14448 美元。耐甲氧西林金黄色葡萄球菌(MRSA)引起的 SSI 使住院时间延长了 19.3 天,额外增加了 7015 美元的费用。

结论

SSI 明显延长了住院时间并增加了医疗支出。本研究揭示的数值进一步强调了采取预防 SSI 措施在医疗经济方面的重要性。

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