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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.

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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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