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Multicenter Study
. 2014 Feb;62(2):306-11.
doi: 10.1111/jgs.12634. Epub 2014 Jan 17.

Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults

Keith S Kaye  1 , Dror Marchaim, Ting-Yi Chen, Timothy Baures, Deverick J Anderson, Yong Choi, Richard Sloane, Kenneth E Schmader
Affiliations
Multicenter Study

Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults

Keith S Kaye et al. J Am Geriatr Soc. 2014 Feb.

Abstract

Objectives: To quantify the effect of nosocomial bloodstream infection (BSI) on older adults, including mortality, length of stay (LOS), and costs attributed to BSI.

Design: Retrospective cohort study.

Setting: Eight acute care hospitals (7 community hospitals and 1 tertiary university-affiliated facility) belonging to the Duke Infection Control Outreach Network (DICON) from the states of North Carolina and Virginia.

Participants: Elderly patients over 65 years of age.

Measurements: A multistate, multicenter, matched, retrospective cohort study was conducted from January 1994 through June 2002 in eight hospitals from the Southern-Central United States. Patients aged >65 years with nosocomial BSI were enrolled. Controls without bloodstream infection were matched to cases. Outcomes during the 90-day period following hospital discharge were evaluated to determine the association between BSI and mortality, hospital costs, and LOS.

Results: Eight-hundred thirty cases and 830 matched controls were identified, all with a mean age of 74.4 years. Among cases, 81% of BSIs were central line-associated and Staphylococcus aureus was the most common pathogen accounting for 34.6% of infections (2/3 were methicillin resistant). The mortality rate of cases was 49.4%, compared to 33.2% for controls (OR = 2.1, P < .001), LOS was 29.2 days for cases and 20.2 days for controls (P < .001), and hospital charges were $102,276 for cases compared to $69,690 for controls (P < .001). The mean LOS and mean costs attributable to BSI were 10 days and $43,208, respectively.

Conclusion: Nosocomial BSI in older adults was significantly associated with increases in 90-day mortality, increased LOS, and increased costs of care. Preventive interventions to eliminate nosocomial BSIs in older adults would likely be cost effective.

Keywords: bacteremia; blood-stream infections; elderly; hospital acquired; methicillin-resistant Staphylococcus aureus; outcome.

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Conflict of interest statement

None of the authors had any conflict of interests to declare regarding the content of this manuscript.

References

    1. Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725–2732. - PubMed
    1. Klevens RM, Edwards JR, Richards CL, Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals 2002. Public Health Rep. 2007;122:160–166. - PMC - PubMed
    1. Al-Rawajfah OM, Stetzer F, Beauchamp Hewitt J. Incidence of and risk factors for nosocomial bloodstream infections in adults in the United States, 2003. Infect Control Hosp Epidemiol. 2009;30:1036–1044. - PubMed
    1. Kim PW, Perl TM, Keelaghan EF, et al. Risk of mortality with a bloodstream infection is higher in the less severely ill at admission. Am J Respir Crit Care Med. 2005;171:616–620. - PubMed
    1. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309–317. - PubMed

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