The cost of infection in hip arthroplasty: a matched case-control study

Abstract

Objective: Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain.

Material and method: Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis.

Results: This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms.

Conclusions: SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.

Keywords: Artroplastia de cadera; Costes hospitalarios; Estancia hospitalaria; Hip arthroplasty; Hospital costs; Infección de localización quirúrgica; Length of stay; Methicillin-resistant Staphylococcus aureus; Staphylococcus aureus resistente a la meticilina; Surgical wound infection.