Harvard Medical School, Boston, MA, 02115, USA.
Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.
Clin Oral Investig. 2022 Feb;26(2):1323-1332. doi: 10.1007/s00784-021-04106-0. Epub 2021 Aug 6.
To evaluate the association and risk factors of healthcare-associated infection (HAI) and burden of illness among chemotherapy-induced ulcerative mucositis (UM) patients.
For this research, US National Inpatient Sample database 2017 was utilized to study UM patients. The association of healthcare-associated infection-related burden of illness among UM patients was assessed on the outcome--length of hospital stays (LOS), total charges, in-hospital mortality, and discharge disposition.
In 2017, there were 11,350 adult (> 18 years of age) UM patients, among them there were 415 (3.5%) HAI. After adjusting for patient and clinical characteristics, UM patients with HAI were most likely to have higher total charges and longer LOS (1.91; 95% CIs: 1.51-2.41; P < 0.001; 1.84; 95% CIs: 1.53-2.21; P < 0.001) than those without HAI. Further, mortality was not significantly different. UM patients with HAI were less likely to have higher burden of illness who were younger, females, those living in non-metropolitan or micropolitan counties, and those with lower co-morbidity score. Additionally, UM patients with HAI were more likely to discharge to skilled nursing facility (SNF), intermediate care facility (ICF), and another type of facility (ATF), (aOR = 2.58 (1.16-5.76), P = 0.02), than they were to discharge to self-care or home care.
UM patients with HAI were more likely to have higher burden of illness and more likely to discharged to the SNF, ICF, and ATF rather than to home or self-care. Clinical relevance UM patients when associated with HAI have higher burden of illness; a tailored approach to oral care might prevent HAIs and burden of illness among UM.
评估与化疗诱导性溃疡性黏膜炎（UM）患者相关的医疗保健相关性感染（HAI）及疾病负担的关联和危险因素。
本研究利用美国国家住院患者样本数据库 2017 年的数据，对 UM 患者进行研究。以住院时间（LOS）、总费用、住院死亡率和出院去向为结局，评估 UM 患者中与 HAI 相关的疾病负担的关联。
2017 年，有 11350 名成年（>18 岁）UM 患者，其中有 415 例（3.5%）发生 HAI。在调整患者和临床特征后，HAI 的 UM 患者更有可能产生更高的总费用和更长的 LOS（1.91；95%置信区间：1.51-2.41；P<0.001；1.84；95%置信区间：1.53-2.21；P<0.001），而非 HAI 的 UM 患者。此外，死亡率无显著差异。年轻、女性、居住在非大都市或小城市县、合并症评分较低的 HAI 的 UM 患者，其疾病负担较低。此外，HAI 的 UM 患者更有可能被送往康复护理机构（SNF）、中级护理机构（ICF）和其他类型的机构（ATF），而不是自理或家庭护理（aOR=2.58（1.16-5.76），P=0.02）。
HAI 的 UM 患者更有可能产生更高的疾病负担，更有可能被送往 SNF、ICF 和 ATF，而不是家庭或自理。临床意义当 UM 患者与 HAI 相关时，其疾病负担更高；采取针对性的口腔护理方法可能会预防 HAI 和 UM 患者的疾病负担。
