Literature DB >> 19896860

Economic aspects of deep sternal wound infections.

Karolin Graf1, Ella Ott, Ralf-Peter Vonberg, Christian Kuehn, Axel Haverich, Iris Freya Chaberny.   

Abstract

OBJECTIVES: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI.
METHODS: A case-control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age +/-5 years, (3) gender and (4) duration of preoperative hospital stay +/-2 days, but at least as long as the time at risk of cases before infection.
RESULTS: Between January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p<0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p=0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference).
CONCLUSION: DSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

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Mesh:

Year:  2009        PMID: 19896860     DOI: 10.1016/j.ejcts.2009.10.005

Source DB:  PubMed          Journal:  Eur J Cardiothorac Surg        ISSN: 1010-7940            Impact factor:   4.191


  41 in total

1.  Effect of surgical incision management on wound infections in a poststernotomy patient population.

Authors:  Onnen Grauhan; Artashes Navasardyan; Baris Tutkun; Felix Hennig; Peter Müller; Manfred Hummel; Roland Hetzer
Journal:  Int Wound J       Date:  2014-06       Impact factor: 3.315

Review 2.  Surgical site infections--economic consequences for the health care system.

Authors:  Karolin Graf; Ella Ott; Ralf-Peter Vonberg; Christian Kuehn; Tobias Schilling; Axel Haverich; Iris Freya Chaberny
Journal:  Langenbecks Arch Surg       Date:  2011-03-15       Impact factor: 3.445

3.  [Strategies to prevent surgical site infections].

Authors:  I F Chaberny; K Graf
Journal:  Unfallchirurg       Date:  2011-03       Impact factor: 1.000

4.  Triclosan-coated sutures and sternal wound infections: a prospective randomized clinical trial.

Authors:  S Steingrimsson; L Thimour-Bergström; C Roman-Emanuel; H Scherstén; Ö Friberg; T Gudbjartsson; A Jeppsson
Journal:  Eur J Clin Microbiol Infect Dis       Date:  2015-10-02       Impact factor: 3.267

5.  Topical spraying of cefazolin and gentamicin reduces deep sternal wound infections after heart surgery: a multicenter, large volume, retrospective study.

Authors:  Hiroshi Osawa; Shinpei Yoshii; Samuel J K Abraham; Yuki Okamoto; Shigeru Hosaka; Shoji Fukuda; Koji Tsuchiya; Masato Nakajima; Yoshihiro Honda; Kouki Takizawa
Journal:  Gen Thorac Cardiovasc Surg       Date:  2015-12-31

6.  A new cable-tie-based sternal closure device: infectious considerations.

Authors:  Ludovic Melly; Brigitta Gahl; Ruth Meinke; Florian Rueter; Peter Matt; Oliver Reuthebuch; Friedrich S Eckstein; Martin T R Grapow
Journal:  Interact Cardiovasc Thorac Surg       Date:  2013-04-26

7.  Prophylactic use of levofloxacin during medicinal leech therapy.

Authors:  Tiene Bauters; Franky Buyle; Stijn Blot; Hugo Robays; Dirk Vogelaers; Koen Van Landuyt; Wim Vanhove; Geert Claeys
Journal:  Int J Clin Pharm       Date:  2014-08-06

8.  Tremendous bleeding complication after vacuum-assisted sternal closure.

Authors:  Arndt H Kiessling; Andreas Lehmann; Frank Isgro; Anton Moritz
Journal:  J Cardiothorac Surg       Date:  2011-02-09       Impact factor: 1.637

9.  Wound complications after median sternotomy: a single-centre study.

Authors:  Claudia Heilmann; Rahel Stahl; Christian Schneider; Tetyana Sukhodolya; Matthias Siepe; Manfred Olschewski; Friedhelm Beyersdorf
Journal:  Interact Cardiovasc Thorac Surg       Date:  2013-01-25

10.  The impact of surgical site occurrences and the role of closed incision negative pressure therapy.

Authors:  Christian Willy; Michael Engelhardt; Marcus Stichling; Onnen Grauhan
Journal:  Int Wound J       Date:  2016-09       Impact factor: 3.315

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