OBJECTIVE: To explore the clinical impact and economic burden of hospital-acquired infections (HAIs) in trauma patients using a nationally representative database. DESIGN: Retrospective study. SETTING: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample. PATIENTS: Trauma patients. MAIN OUTCOME MEASURES: We examined the association between HAIs (sepsis, pneumonia, Staphylococcus infections, and Clostridium difficile- associated disease) and in-hospital mortality, length of stay, and inpatient costs using logistic regression and generalized linear models. RESULTS: After controlling for patient demographics, mechanism of injury, injury type, injury severity, and comorbidities, we found that mortality, cost, and length of stay were significantly higher in patients with HAIs compared with patients without HAIs. Patients with sepsis had a nearly 6-fold higher odds of death compared with patients without an HAI (odds ratio, 5.78; 95% confidence interval, 5.03-6.64; P < .001). Patients with other HAIs had a 1.5- to 1.9-fold higher odds of mortality compared with controls (P < .005). Patients with HAIs had costs that were approximately 2- to 2.5-fold higher compared with patients without HAIs (P < .001). The median length of stay was approximately 2-fold higher in patients with HAIs compared with patients without HAIs (P < .001). CONCLUSIONS: Trauma patients with HAIs are at increased risk for mortality, have longer lengths of stay, and incur higher inpatient costs. In light of the preventability of many HAIs and the magnitude of the clinical and economic burden associated with HAIs, policies aiming to decrease the incidence of HAIs may have a potentially large impact on outcomes in injured patients.
OBJECTIVE: To explore the clinical impact and economic burden of hospital-acquired infections (HAIs) in traumapatients using a nationally representative database. DESIGN: Retrospective study. SETTING: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample. PATIENTS: Traumapatients. MAIN OUTCOME MEASURES: We examined the association between HAIs (sepsis, pneumonia, Staphylococcus infections, and Clostridium difficile- associated disease) and in-hospital mortality, length of stay, and inpatient costs using logistic regression and generalized linear models. RESULTS: After controlling for patient demographics, mechanism of injury, injury type, injury severity, and comorbidities, we found that mortality, cost, and length of stay were significantly higher in patients with HAIs compared with patients without HAIs. Patients with sepsis had a nearly 6-fold higher odds of death compared with patients without an HAI (odds ratio, 5.78; 95% confidence interval, 5.03-6.64; P < .001). Patients with other HAIs had a 1.5- to 1.9-fold higher odds of mortality compared with controls (P < .005). Patients with HAIs had costs that were approximately 2- to 2.5-fold higher compared with patients without HAIs (P < .001). The median length of stay was approximately 2-fold higher in patients with HAIs compared with patients without HAIs (P < .001). CONCLUSIONS:Traumapatients with HAIs are at increased risk for mortality, have longer lengths of stay, and incur higher inpatient costs. In light of the preventability of many HAIs and the magnitude of the clinical and economic burden associated with HAIs, policies aiming to decrease the incidence of HAIs may have a potentially large impact on outcomes in injured patients.
Authors: Kevin Laupland; Daniel B Gregson; Andrew W Kirkpatrick; John B Kortbeek; David A Zygun; Christi Findlay; S Morad Hameed Journal: Clin Invest Med Date: 2004-10 Impact factor: 0.825
Authors: Grant V Bochicchio; Lena M Napolitano; Manjari Joshi; Kelly Knorr; J Kathleen Tracy; Obeid Ilahi; Thomas M Scalea Journal: J Trauma Date: 2002-08
Authors: Maher M El-Masri; Tarek A Hammad; Sandra W McLeskey; Manjari Joshi; Denise M Korniewicz Journal: Infect Control Hosp Epidemiol Date: 2004-08 Impact factor: 3.254
Authors: Emanuel Eguia; Adrienne N Cobb; Marshall S Baker; Cara Joyce; Emily Gilbert; Richard Gonzalez; Majid Afshar; Matthew M Churpek Journal: Am J Surg Date: 2019-03-08 Impact factor: 2.565
Authors: Jose Paul Perales Villarroel; Yuxia Guan; Evan Werlin; Mary A Selak; Lance B Becker; Carrie A Sims Journal: J Trauma Acute Care Surg Date: 2013-07 Impact factor: 3.313
Authors: Matthew Mossanen; Joshua K Calvert; Sarah K Holt; Andrew C James; Jonathan L Wright; Jonathan D Harper; John N Krieger; John L Gore Journal: J Urol Date: 2014-09-06 Impact factor: 7.450