TY - JOUR
T1 - A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections
AU - Herwaldt, Loreen A.
AU - Cullen, Joseph J.
AU - Scholz, David
AU - French, Pamela
AU - Zimmerman, M. Bridget
AU - Pfaller, Michael A.
AU - Wenzel, Richard P.
AU - Perl, Trish M.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/12
Y1 - 2006/12
N2 - OBJECTIVE. We evaluated 4 important outcomes associated with postoperative nosocomial infection: costs, mortality, excess length of stay, and utilization of healthcare resources. DESIGN. The outcomes for patients who underwent general, cardiothoracic, and neurosurgical operations were recorded during a previous clinical trial. Multivariable analyses including significant covariates were conducted to determine whether nosocomial infection significantly affected the outcomes. SETTING. A large tertiary care medical center and an affiliated Veterans Affairs Medical Center. PATIENTS. A total of 3,864 surgical patients. RESULTS. The overall nosocomial infection rate was 11.3%. Important covariates included age, Karnofsky score, McCabe and Jackson classification of the severity of underlying disease, National Nosocomial Infection Surveillance system risk index, and number of comorbidities. After accounting for covariates, nosocomial infection was associated with increased postoperative length of stay, increased costs, increased hospital readmission rate, and increased use of antimicrobial agents in the outpatient setting. Nosocomial infection was not associated independently with a significantly increased risk of death in this surgical population. CONCLUSION. Postoperative nosocomial infection was associated with increased costs of care and with increased utilization of medical resources. To accurately assess the effects of nosocomial infections, one must take into account important covariates. Surgeons seeking to decrease the cost of care and resource utilization must identify ways to decrease the rate of postoperative nosocomial infection.
AB - OBJECTIVE. We evaluated 4 important outcomes associated with postoperative nosocomial infection: costs, mortality, excess length of stay, and utilization of healthcare resources. DESIGN. The outcomes for patients who underwent general, cardiothoracic, and neurosurgical operations were recorded during a previous clinical trial. Multivariable analyses including significant covariates were conducted to determine whether nosocomial infection significantly affected the outcomes. SETTING. A large tertiary care medical center and an affiliated Veterans Affairs Medical Center. PATIENTS. A total of 3,864 surgical patients. RESULTS. The overall nosocomial infection rate was 11.3%. Important covariates included age, Karnofsky score, McCabe and Jackson classification of the severity of underlying disease, National Nosocomial Infection Surveillance system risk index, and number of comorbidities. After accounting for covariates, nosocomial infection was associated with increased postoperative length of stay, increased costs, increased hospital readmission rate, and increased use of antimicrobial agents in the outpatient setting. Nosocomial infection was not associated independently with a significantly increased risk of death in this surgical population. CONCLUSION. Postoperative nosocomial infection was associated with increased costs of care and with increased utilization of medical resources. To accurately assess the effects of nosocomial infections, one must take into account important covariates. Surgeons seeking to decrease the cost of care and resource utilization must identify ways to decrease the rate of postoperative nosocomial infection.
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U2 - 10.1086/509827
DO - 10.1086/509827
M3 - Article
C2 - 17152025
AN - SCOPUS:33846011877
SN - 0899-823X
VL - 27
SP - 1291
EP - 1298
JO - Infection control and hospital epidemiology
JF - Infection control and hospital epidemiology
IS - 12
ER -