Salmanton-García J, Bruns C, Rutz J, Albertsmeier M, Ankert J, Bernard L, Bataille C, Couvé-Deacon E, Fernández-Ferrer M, Fortún J, Galar A, Grill E, Guimard T, Classen A Y, Vehreschild J J, Stemler J, Naendrup J-H, Hampl J, Tallon B, Sprute R, Horcajada J P, Mollar-Maseres J, Muñoz P, Pletz M W, Serracino-Inglott F, Soriano A, Vilz T O, Seifert H, Cornely O A, Mellinghoff S C, Liss B J, Wingen-Heimann S M
Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany.
J Hosp Infect. 2024 May;147:123-132. doi: 10.1016/j.jhin.2024.02.019. Epub 2024 Mar 11.
Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus.
To conduct a case-control study on the economic impact of S. aureus SSI in adult surgical patients across high-volume centres in France, Germany, Spain, and the UK, aiming to assess the overall and procedure-specific burden across Europe.
The SALT study is a multinational, retrospective cohort study with a nested case-control analysis focused on S. aureus SSI in Europe. The study included participants from France, Germany, Italy, Spain, and the UK who underwent invasive surgery in 2016 and employed a micro-costing approach to evaluate health economic factors, matching S. aureus SSI cases with controls.
In 2016, among 178,904 surgical patients in five European countries, 764 developed S. aureus SSI. Matching 744 cases to controls, the study revealed that S. aureus SSI cases incurred higher immediate hospitalization costs (€8,810), compared to controls (€6,032). Additionally, S. aureus SSI cases exhibited increased costs for readmissions within the first year post surgery (€7,961.6 versus €5,298.6), with significant differences observed. Factors associated with increased surgery-related costs included the cost of hospitalization immediately after surgery, first intensive care unit (ICU) admission within 12 months, and hospital readmission within 12 months, as identified through multivariable analysis.
The higher rates of hospitalization, ICU admissions, and readmissions among S. aureus SSI cases highlight the severity of these infections and their impact on healthcare costs, emphasizing the potential benefits of evidence-based infection control measures and improved patient care to mitigate the economic burden.
手术部位感染（SSIs）主要由金黄色葡萄球菌引起，在欧洲造成了巨大的经济负担，导致住院时间延长、死亡率上升以及治疗成本增加，尤其是耐甲氧西林金黄色葡萄球菌等耐药菌株所致的感染。
在法国、德国、西班牙和英国的大型中心对成年外科手术患者中金黄色葡萄球菌手术部位感染的经济影响进行病例对照研究，旨在评估整个欧洲以及特定手术的负担情况。
SALT研究是一项多国回顾性队列研究，并进行了嵌套病例对照分析，重点关注欧洲的金黄色葡萄球菌手术部位感染。该研究纳入了2016年在法国、德国、意大利、西班牙和英国接受侵入性手术的参与者，并采用微观成本核算方法评估健康经济因素，将金黄色葡萄球菌手术部位感染病例与对照进行匹配。
2016年，在五个欧洲国家的178,904名外科手术患者中，有764人发生了金黄色葡萄球菌手术部位感染。将744例病例与对照进行匹配后，研究发现金黄色葡萄球菌手术部位感染病例的直接住院费用（8810欧元）高于对照（6032欧元）。此外，金黄色葡萄球菌手术部位感染病例术后第一年再次入院的费用也有所增加（7961.6欧元对5298.6欧元），差异显著。通过多变量分析确定，与手术相关成本增加相关的因素包括术后立即住院费用、术后12个月内首次入住重症监护病房（ICU）以及术后12个月内再次入院。
金黄色葡萄球菌手术部位感染病例的住院率、ICU入住率和再次入院率较高，凸显了这些感染的严重性及其对医疗成本的影响，强调了基于证据的感染控制措施和改善患者护理以减轻经济负担的潜在益处。
