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Costs associated with health care-associated infections in cardiac surgery.

Publication ,  Journal Article
Greco, G; Shi, W; Michler, RE; Meltzer, DO; Ailawadi, G; Hohmann, SF; Thourani, VH; Argenziano, M; Alexander, JH; Sankovic, K; Gupta, L ...
Published in: J Am Coll Cardiol
January 6, 2015

BACKGROUND: Health care-associated infections (HAIs) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. Current information about their economic burden is limited. OBJECTIVES: This research was designed to determine the cost associated with major types of HAIs during the first 2 months after cardiac surgery. METHODS: Prospectively collected data from a multicenter, observational study of the Cardiothoracic Surgery Clinical Trials Network, in which patients were monitored for infections for 65 days after surgery, were merged with related financial data routinely collected by the University HealthSystem Consortium. Incremental length of stay (LOS) and cost associated with HAIs were estimated using generalized linear models, with adjustments for patient demographics, clinical history, baseline laboratory values, and surgery type. RESULTS: Among 4,320 cardiac surgery patients (mean age: 64 ± 13 years), 119 (2.8%) experienced a major HAI during the index hospitalization. The most common HAIs were pneumonia (48%), sepsis (20%), and Clostridium difficile colitis (18%). On average, the estimated incremental cost associated with a major HAI was nearly $38,000, of which 47% was related to intensive care unit services. The incremental LOS was 14 days. Overall, there were 849 readmissions; among these, 8.7% were attributed to major HAIs. The cost of readmissions due to major HAIs was, on average, nearly threefold that of readmissions not related to HAIs. CONCLUSIONS: Hospital cost, LOS, and readmissions are strongly associated with HAIs. These associations suggest the potential for large reductions in costs if HAIs following cardiac surgery can be reduced. (Management Practices and the Risk of Infections Following Cardiac Surgery; NCT01089712).

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

January 6, 2015

Volume

65

Issue

1

Start / End Page

15 / 23

Location

United States

Related Subject Headings

  • Middle Aged
  • Male
  • Linear Models
  • Length of Stay
  • Humans
  • Hospital Costs
  • Female
  • Cross Infection
  • Cost of Illness
  • Cardiovascular System & Hematology
 

Citation

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Greco, G., Shi, W., Michler, R. E., Meltzer, D. O., Ailawadi, G., Hohmann, S. F., … Gardner, T. J. (2015). Costs associated with health care-associated infections in cardiac surgery. J Am Coll Cardiol, 65(1), 15–23. https://doi.org/10.1016/j.jacc.2014.09.079
Greco, Giampaolo, Wei Shi, Robert E. Michler, David O. Meltzer, Gorav Ailawadi, Samuel F. Hohmann, Vinod H. Thourani, et al. “Costs associated with health care-associated infections in cardiac surgery.J Am Coll Cardiol 65, no. 1 (January 6, 2015): 15–23. https://doi.org/10.1016/j.jacc.2014.09.079.
Greco G, Shi W, Michler RE, Meltzer DO, Ailawadi G, Hohmann SF, et al. Costs associated with health care-associated infections in cardiac surgery. J Am Coll Cardiol. 2015 Jan 6;65(1):15–23.
Greco, Giampaolo, et al. “Costs associated with health care-associated infections in cardiac surgery.J Am Coll Cardiol, vol. 65, no. 1, Jan. 2015, pp. 15–23. Pubmed, doi:10.1016/j.jacc.2014.09.079.
Greco G, Shi W, Michler RE, Meltzer DO, Ailawadi G, Hohmann SF, Thourani VH, Argenziano M, Alexander JH, Sankovic K, Gupta L, Blackstone EH, Acker MA, Russo MJ, Lee A, Burks SG, Gelijns AC, Bagiella E, Moskowitz AJ, Gardner TJ. Costs associated with health care-associated infections in cardiac surgery. J Am Coll Cardiol. 2015 Jan 6;65(1):15–23.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

January 6, 2015

Volume

65

Issue

1

Start / End Page

15 / 23

Location

United States

Related Subject Headings

  • Middle Aged
  • Male
  • Linear Models
  • Length of Stay
  • Humans
  • Hospital Costs
  • Female
  • Cross Infection
  • Cost of Illness
  • Cardiovascular System & Hematology