• Home
  1. Home
  2. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality
Scientific article
English

Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality

Contributors

Pittet, Didier; Tarara, D.; Wenzel, R. P.

Published in

JAMA, vol. 271, no. 20, p. 1598-1601

Publication date

1994

Abstract

OBJECTIVE: To determine the excess length of stay, extra costs, and mortality attributable to nosocomial bloodstream infection in critically ill patients. DESIGN: Pairwise-matched (1:1) case-control study. SETTING: Surgical intensive care unit (SICU) in a tertiary health care institution. PATIENTS: All patients admitted in the SICU between July 1, 1988, and June 30, 1990, were eligible. Cases were defined as patients with nosocomial bloodstream infection; controls were selected according to matching variables in a stepwise fashion. METHODS: Matching variables were primary diagnosis for admission, age, sex, length of stay before the day of infection in cases, and total number of discharge diagnoses. Matching was successful for 89% of the cohort; 86 matched case-control pairs were studied. MAIN OUTCOME MEASURES: Crude and attributable mortality, excess length of hospital and SICU stay, and overall costs. RESULTS: Nosocomial bloodstream infection complicated 2.67 per 100 admissions to the SICU during the study period. The crude mortality rates from cases and controls were 50% and 15%, respectively (P <.01); thus, the estimated attributable mortality rate was 35% (95% confidence interval, 25% to 45%). The median length of hospital stay significantly differed between cases and controls (40 vs 26 days, respectively; P <.01). When only matched pairs who survived bloodstream infection were considered (n = 41), cases stayed in the hospital a median of 54 days vs 30 days for controls (P <.01), and cases stayed in the SICU a median of 15 days vs 7 days for controls (P <.01). Thus, extra hospital and SICU length of stay attributable to bloodstream infection was 24 and 8 days, respectively. Extra costs attributable to the infection averaged

Keywords

  • Case-Control Studies
  • Critical Illness
  • Cross Infection/ economics/ mortality
  • Hospital Bed Capacity, 500 and over
  • Hospital Costs/statistics & numerical data
  • Hospital Mortality
  • Hospitals, University/economics
  • Humans
  • Intensive Care Units/ economics/statistics & numerical data
  • Iowa
  • Length of Stay/economics/statistics & numerical data
  • Sepsis/ economics/ mortality
  • Survival Rate

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

PITTET, Didier, TARARA, D., WENZEL, R. P. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. In: JAMA, 1994, vol. 271, n° 20, p. 1598–1601. doi: 10.1097/00132586-199412000-00063

Main files (1)

Article

Identifiers

Additional URL for this publication

http://jama.ama-assn.org/cgi/content/abstract/271/20/1598

Journal ISSN

0098-7484
622views
0downloads

Technical informations

Creation

21/06/2010 10:25:59

First validation

21/06/2010 10:25:59

Update

14/03/2023 15:45:11

Status update

14/03/2023 15:45:11

Last indexation

29/10/2024 15:17:19
All rights reserved by Archive ouverte UNIGE and the University of Geneva
OpenAIRE Indexed & Validated