Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs
This study aimed to determine the excess length of stay, extra expenditures, and attributable mortality to healthcare-associated S. aureus bloodstream infection (BSI) at a teaching hospital in central Brazil. The study design was a matched (1:1) case-control. Cases were defined as patients > 13 y...
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| Format: | Article |
| Language: | English |
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Elsevier
2012-12-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702012000600001 |
| _version_ | 1818281795946283008 |
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| author | Mariusa Gomes Borges Primo Adriana Oliveira Guilarde Celina M. Turchi Martelli Lindon Johnson de Abreu Batista Marília Dalva Turchi |
| author_facet | Mariusa Gomes Borges Primo Adriana Oliveira Guilarde Celina M. Turchi Martelli Lindon Johnson de Abreu Batista Marília Dalva Turchi |
| author_sort | Mariusa Gomes Borges Primo |
| collection | DOAJ |
| description | This study aimed to determine the excess length of stay, extra expenditures, and attributable mortality to healthcare-associated S. aureus bloodstream infection (BSI) at a teaching hospital in central Brazil. The study design was a matched (1:1) case-control. Cases were defined as patients > 13 years old, with a healthcare-associated S. aureus BSI. Controls included patients without an S. aureus BSI, who were matched to cases by gender, age (± 7 years), morbidity, and underlying disease. Data were collected from medical records and from the Brazilian National Hospital Information System (Sistema de Informações Hospitalares do Sistema Único de Saúde - SIH/SUS). A Wilcoxon rank sum test was performed to compare length of stay and costs between cases and controls. Differences in mortality between cases and controls were compared using McNemar's tests. The Mantel-Haenzel stratified analysis was performed to compare invasive device utilization. Data analyses were conducted using Epi Info 6.0 and Statistical Package for Social Sciences (SPSS 13.0). 84 case-control pairs matched by gender, age, admission period, morbidity, and underlying disease were analyzed. The mean lengths of hospital stay were 48.3 and 16.2 days for cases and controls, respectively (p < 0.01), yielding an excess hospital stay among cases of 32.1 days. the excess mortality among cases compared to controls that was attributable to s. aureus bloodstream infection was 45.2%. Cases had a higher risk of dying compared to controls (OR 7.3, 95% CI 3.1-21.1). Overall costs of hospitalization (SIH/SUS) reached US$ 123,065 for cases versus US$ 40,247 for controls (p < 0.01). the cost of antimicrobial therapy was 6.7 fold higher for cases compared to controls. healthcare-associated s. aureus BSI was associated with statistically significant increases in length of hospitalization, attributable mortality, and economic burden. Implementation of measures to minimize the risk of healthcare-associated bacterial infections is essential. |
| first_indexed | 2024-12-13T00:10:48Z |
| format | Article |
| id | doaj.art-b7fe6f95b19043d9a3f94d9b3ba03952 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 1678-4391 |
| language | English |
| last_indexed | 2024-12-13T00:10:48Z |
| publishDate | 2012-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-b7fe6f95b19043d9a3f94d9b3ba039522022-12-22T00:06:00ZengElsevierBrazilian Journal of Infectious Diseases1413-86701678-43912012-12-0116650350910.1590/S1413-86702012000600001Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costsMariusa Gomes Borges PrimoAdriana Oliveira GuilardeCelina M. Turchi MartelliLindon Johnson de Abreu BatistaMarília Dalva TurchiThis study aimed to determine the excess length of stay, extra expenditures, and attributable mortality to healthcare-associated S. aureus bloodstream infection (BSI) at a teaching hospital in central Brazil. The study design was a matched (1:1) case-control. Cases were defined as patients > 13 years old, with a healthcare-associated S. aureus BSI. Controls included patients without an S. aureus BSI, who were matched to cases by gender, age (± 7 years), morbidity, and underlying disease. Data were collected from medical records and from the Brazilian National Hospital Information System (Sistema de Informações Hospitalares do Sistema Único de Saúde - SIH/SUS). A Wilcoxon rank sum test was performed to compare length of stay and costs between cases and controls. Differences in mortality between cases and controls were compared using McNemar's tests. The Mantel-Haenzel stratified analysis was performed to compare invasive device utilization. Data analyses were conducted using Epi Info 6.0 and Statistical Package for Social Sciences (SPSS 13.0). 84 case-control pairs matched by gender, age, admission period, morbidity, and underlying disease were analyzed. The mean lengths of hospital stay were 48.3 and 16.2 days for cases and controls, respectively (p < 0.01), yielding an excess hospital stay among cases of 32.1 days. the excess mortality among cases compared to controls that was attributable to s. aureus bloodstream infection was 45.2%. Cases had a higher risk of dying compared to controls (OR 7.3, 95% CI 3.1-21.1). Overall costs of hospitalization (SIH/SUS) reached US$ 123,065 for cases versus US$ 40,247 for controls (p < 0.01). the cost of antimicrobial therapy was 6.7 fold higher for cases compared to controls. healthcare-associated s. aureus BSI was associated with statistically significant increases in length of hospitalization, attributable mortality, and economic burden. Implementation of measures to minimize the risk of healthcare-associated bacterial infections is essential.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702012000600001Staphylococcus aureusBloodstream infectionAttributable mortalityLength of stayExtra costs |
| spellingShingle | Mariusa Gomes Borges Primo Adriana Oliveira Guilarde Celina M. Turchi Martelli Lindon Johnson de Abreu Batista Marília Dalva Turchi Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs Brazilian Journal of Infectious Diseases Staphylococcus aureus Bloodstream infection Attributable mortality Length of stay Extra costs |
| title | Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs |
| title_full | Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs |
| title_fullStr | Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs |
| title_full_unstemmed | Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs |
| title_short | Healthcare-associated Staphylococcus aureus bloodstream infection: length of stay, attributable mortality, and additional direct costs |
| title_sort | healthcare associated staphylococcus aureus bloodstream infection length of stay attributable mortality and additional direct costs |
| topic | Staphylococcus aureus Bloodstream infection Attributable mortality Length of stay Extra costs |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702012000600001 |
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