Sankaran Satheeshkumar P, Villa Alessandro, Sonis Stephen
Harvard Medical School, Boston MA, USA.
Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA.
Infect Prev Pract. 2021 Jan 13;3(1):100115. doi: 10.1016/j.infpip.2021.100115. eCollection 2021 Mar.
The negative consequences of healthcare-associated infections (HAI) on the burden of illness (BOI) of cancer patients are well-established. However, there is a paucity of research on HAI among cancers of the lip, oral cavity and pharynx (CLOCP), and whether HAI-related BOI differed for other common solid tumors-malignant neoplasm of the colon (MNC) and malignant neoplasm of the lung (MNL).
We utilized the United States' National Inpatient Sample database 2017 to study longitudinal inpatient hospital stay of CLOCP, MNC and MNL. Patient demographics and hospital characteristics of patients were assessed, and the impact of HAI-related BOI compared based on differences in length of hospital stays (LOS), total charges during hospitalization and mortality were compared.
In 2017, of the 54,934 patients with CLOCP, 1.2% had HAI, compared to MNC (n=64,470) with 2% HAI and MNL (n=154,685) with 1.2% HAI. In adjusted multivariable regression analysis, we determined CLOCP patients with HAI had LOS of 5.6 days longer (95% CIs, 3.0-8.2 days, < 0.001), and hospitalization charges of $40,341 higher (95%CIs 15,715-64,967, < 0.01) than the non-HAI CLOCP patients. Mortality was not significantly different among HAI and non-HAI CLOCP patients (odds ratio: 0.80; 95%CIs 0.35-1.87, = 0.6). In unadjusted analysis, LOS and total charges were higher for CLOCP-HAI patients vs. MNC-HAI or MNL-HAI patients.
HAI in patients with CLOCP patients were associated with an increased BOI, and this is considerably higher than observed in patients with MNC or MNL patients who had HAI.
医疗保健相关感染（HAI）对癌症患者疾病负担（BOI）的负面影响已得到充分证实。然而，关于唇、口腔和咽癌（CLOCP）患者中HAI的研究较少，以及HAI相关的疾病负担在其他常见实体瘤——结肠癌（MNC）和肺癌（MNL）中是否存在差异。
我们利用2017年美国国家住院样本数据库研究CLOCP、MNC和MNL患者的纵向住院时间。评估了患者的人口统计学特征和医院特征，并根据住院时间（LOS）差异、住院期间总费用以及死亡率比较了HAI相关疾病负担的影响。
2017年，54934例CLOCP患者中，1.2%发生了HAI，相比之下，MNC患者（n = 64470）中HAI发生率为2%，MNL患者（n = 154685）中HAI发生率为1.2%。在调整后的多变量回归分析中，我们确定发生HAI的CLOCP患者住院时间比未发生HAI的CLOCP患者长5.6天（95%置信区间，3.0 - 8.2天，< 0.001），住院费用比未发生HAI的CLOCP患者高40341美元（95%置信区间15715 - 64967，< 0.01）。HAI和未发生HAI的CLOCP患者之间的死亡率无显著差异（优势比：0.80；95%置信区间0.35 - 1.87，P = 0.6）。在未调整分析中，CLOCP-HAI患者的住院时间和总费用高于MNC-HAI或MNL-HAI患者。
CLOCP患者中的HAI与疾病负担增加相关，且这一负担显著高于发生HAI的MNC或MNL患者。
