Axel Findeisen1, Habibollah Arefian2,3, Torsten Doenst4, Stefan Hagel2,5, Mathias W Pletz5, Michael Hartmann2,3, Jens Maschmann6. 1. Faculty of Medicine, Friedrich Schiller University Jena, Jena, Germany. 2. Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany. 3. Hospital Pharmacy, Jena University Hospital, Jena, Germany. 4. Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany. 5. Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany. 6. Jena University Hospital, Jena, Germany.
Abstract
OBJECTIVES: This study aimed to determine the additional costs and length of stay (LOS) due to surgical site infections (SSIs) after coronary artery bypass grafting (CABG) at Jena University Hospital. METHODS: The data of 999 consecutive patients who underwent CABG from January 2013 to December 2014 were collected. We extracted the number, type and duration of antimicrobial therapy and V.A.C.® therapy (negative pressure wound therapy) treatments and calculated the additional SSI-related costs based on the hospital's perspective. We also evaluated the prolongation of LOS using a multistate model and calculated the costs due to the additional LOS. RESULTS: In total, 983 patients were included in our analysis, and 126 patients with SSIs following CABG were identified during the study period; 124 patients with SSIs (98.4%) were discharged alive. The mean cost of antimicrobial therapy to treat the SSIs was €818 [95% confidence interval (CI) 392-1245], and the mean cost of V.A.C. therapy was €1179 (95% CI 748-1610) per infected patient. The mean additional LOS due to SSIs (±standard error) was estimated to be 9.3 ± 2.6 days. The cost per SSI-infected patient attributable to the additional LOS was €9444 (95% CI 4242-14 645). CONCLUSIONS: SSIs following CABG are associated with an additional LOS and a significant economic burden depending on the classification of SSI. A very important component of the additional cost is the prolongation of LOS. Therefore, it is essential to shorten the hospital stay due to SSIs as far as possible.
OBJECTIVES: This study aimed to determine the additional costs and length of stay (LOS) due to surgical site infections (SSIs) after coronary artery bypass grafting (CABG) at Jena University Hospital. METHODS: The data of 999 consecutive patients who underwent CABG from January 2013 to December 2014 were collected. We extracted the number, type and duration of antimicrobial therapy and V.A.C.® therapy (negative pressure wound therapy) treatments and calculated the additional SSI-related costs based on the hospital's perspective. We also evaluated the prolongation of LOS using a multistate model and calculated the costs due to the additional LOS. RESULTS: In total, 983 patients were included in our analysis, and 126 patients with SSIs following CABG were identified during the study period; 124 patients with SSIs (98.4%) were discharged alive. The mean cost of antimicrobial therapy to treat the SSIs was €818 [95% confidence interval (CI) 392-1245], and the mean cost of V.A.C. therapy was €1179 (95% CI 748-1610) per infectedpatient. The mean additional LOS due to SSIs (±standard error) was estimated to be 9.3 ± 2.6 days. The cost per SSI-infectedpatient attributable to the additional LOS was €9444 (95% CI 4242-14 645). CONCLUSIONS: SSIs following CABG are associated with an additional LOS and a significant economic burden depending on the classification of SSI. A very important component of the additional cost is the prolongation of LOS. Therefore, it is essential to shorten the hospital stay due to SSIs as far as possible.
Authors: Johanneke Hartog; Fredrike Blokzijl; Sandra Dijkstra; Mike J L DeJongste; Michiel F Reneman; Willem Dieperink; Iwan C C van der Horst; Joke Fleer; Lucas H V van der Woude; Pim van der Harst; Massimo A Mariani Journal: BMJ Open Date: 2019-09-18 Impact factor: 2.692