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Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital.
Crit Care Med. 2006 Aug; 34(8):2084-9.CC

Abstract

OBJECTIVE

To determine the attributable cost and length of stay of intensive care unit (ICU)-acquired, catheter-associated bloodstream infections from a hospital-based cost perspective, after adjusting for potential confounders.

DESIGN

Patients admitted to the ICU between January 19, 1998, and July 31, 2000, were observed prospectively for the occurrence of catheter-associated bloodstream infections. Hospital costs were obtained from the hospital cost accounting database.

SETTING

The medical and surgical ICUs at a 500-bed suburban, tertiary care hospital.

PATIENTS

Patients requiring central venous catheterization while in the ICU.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We measured occurrence of catheter-associated bloodstream infection, in-hospital mortality rate, total ICU and hospital lengths of stay, and total hospital costs. Catheter-associated bloodstream infection occurred in 41 of 1,132 patients (3.6 cases per 1000 catheter days). Patients with catheter-associated bloodstream infection had significantly higher unadjusted ICU length of stay (median, 24 vs. 5 days; p < .001), hospital length of stay (median, 45 vs. 11 days; p < .001), mortality rate (21 [51%] vs. 301 [28%], p = .001), and total hospital costs (83,544 dollars vs. 23,803 dollars, p < .001). Controlling for other factors that may affect costs and lengths of stay, catheter-associated bloodstream infections resulted in an attributable cost of 11,971 dollars (95% confidence interval, 6,732 dollars-18,352 dollars), ICU length of stay of 2.41 days (95% confidence interval, 0.08-3.09 days), and hospital length of stay of 7.54 days (95% confidence interval, 3.99-11.09 days).

CONCLUSIONS

Patients with catheter-associated bloodstream infection had significantly longer ICU and hospital lengths of stay, with higher unadjusted total mortality rate and hospital cost compared with uninfected patients. After adjusting for underlying severity of illness, the attributable cost of catheter-associated bloodstream infection was approximately 11,971 dollars.

Authors+Show Affiliations

Divisions of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16763511

Citation

Warren, David K., et al. "Attributable Cost of Catheter-associated Bloodstream Infections Among Intensive Care Patients in a Nonteaching Hospital." Critical Care Medicine, vol. 34, no. 8, 2006, pp. 2084-9.
Warren DK, Quadir WW, Hollenbeak CS, et al. Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. Crit Care Med. 2006;34(8):2084-9.
Warren, D. K., Quadir, W. W., Hollenbeak, C. S., Elward, A. M., Cox, M. J., & Fraser, V. J. (2006). Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. Critical Care Medicine, 34(8), 2084-9.
Warren DK, et al. Attributable Cost of Catheter-associated Bloodstream Infections Among Intensive Care Patients in a Nonteaching Hospital. Crit Care Med. 2006;34(8):2084-9. PubMed PMID: 16763511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. AU - Warren,David K, AU - Quadir,Wasim W, AU - Hollenbeak,Christopher S, AU - Elward,Alexis M, AU - Cox,Michael J, AU - Fraser,Victoria J, PY - 2006/6/10/pubmed PY - 2006/9/1/medline PY - 2006/6/10/entrez SP - 2084 EP - 9 JF - Critical care medicine JO - Crit Care Med VL - 34 IS - 8 N2 - OBJECTIVE: To determine the attributable cost and length of stay of intensive care unit (ICU)-acquired, catheter-associated bloodstream infections from a hospital-based cost perspective, after adjusting for potential confounders. DESIGN: Patients admitted to the ICU between January 19, 1998, and July 31, 2000, were observed prospectively for the occurrence of catheter-associated bloodstream infections. Hospital costs were obtained from the hospital cost accounting database. SETTING: The medical and surgical ICUs at a 500-bed suburban, tertiary care hospital. PATIENTS: Patients requiring central venous catheterization while in the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We measured occurrence of catheter-associated bloodstream infection, in-hospital mortality rate, total ICU and hospital lengths of stay, and total hospital costs. Catheter-associated bloodstream infection occurred in 41 of 1,132 patients (3.6 cases per 1000 catheter days). Patients with catheter-associated bloodstream infection had significantly higher unadjusted ICU length of stay (median, 24 vs. 5 days; p < .001), hospital length of stay (median, 45 vs. 11 days; p < .001), mortality rate (21 [51%] vs. 301 [28%], p = .001), and total hospital costs (83,544 dollars vs. 23,803 dollars, p < .001). Controlling for other factors that may affect costs and lengths of stay, catheter-associated bloodstream infections resulted in an attributable cost of 11,971 dollars (95% confidence interval, 6,732 dollars-18,352 dollars), ICU length of stay of 2.41 days (95% confidence interval, 0.08-3.09 days), and hospital length of stay of 7.54 days (95% confidence interval, 3.99-11.09 days). CONCLUSIONS: Patients with catheter-associated bloodstream infection had significantly longer ICU and hospital lengths of stay, with higher unadjusted total mortality rate and hospital cost compared with uninfected patients. After adjusting for underlying severity of illness, the attributable cost of catheter-associated bloodstream infection was approximately 11,971 dollars. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/16763511/Attributable_cost_of_catheter_associated_bloodstream_infections_among_intensive_care_patients_in_a_nonteaching_hospital_ DB - PRIME DP - Unbound Medicine ER -