Economic aspects of deep sternal wound infections
Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the n...
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Published in | European journal of cardio-thoracic surgery Vol. 37; no. 4; pp. 893 - 896 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Elsevier Science B.V
01.04.2010
Oxford University Press |
Subjects | |
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Abstract | Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI. Methods: A case–control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age ±5 years, (3) gender and (4) duration of preoperative hospital stay ±2 days, but at least as long as the time at risk of cases before infection. Results: Between January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p ≪ 0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p = 0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference). Conclusion: DSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. |
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AbstractList | Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI. Methods: A case–control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age ±5 years, (3) gender and (4) duration of preoperative hospital stay ±2 days, but at least as long as the time at risk of cases before infection. Results: Between January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p ≪ 0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p = 0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference). Conclusion: DSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. Abstract Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI. Methods: A case-control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age ±5 years, (3) gender and (4) duration of preoperative hospital stay ±2 days, but at least as long as the time at risk of cases before infection. Results: Between January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p ≪ 0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p = 0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference). Conclusion: DSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. OBJECTIVESSurgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI.METHODSA case-control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age +/-5 years, (3) gender and (4) duration of preoperative hospital stay +/-2 days, but at least as long as the time at risk of cases before infection.RESULTSBetween January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p<0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p=0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference).CONCLUSIONDSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the LOS in the hospital and on an intensive care unit (ICU) as well as the total costs for patients undergoing CABG depending upon the occurrence of a subsequent DSWI. A case-control study was performed. Total costs of DSWI cases were analysed and compared to patients undergoing CABG without DSWI. Inclusion criterion for cases was the development of a DSWI according to the CDC criteria during hospital stay after CABG. Two control patients without any signs or symptoms of an infection during hospital stay were matched to each case by (1) type of surgery according to their diagnosis-related group (DRG), (2) age +/-5 years, (3) gender and (4) duration of preoperative hospital stay +/-2 days, but at least as long as the time at risk of cases before infection. Between January 2006 and March 2008, 17 CABG patients with DSWI (cases) and 34 matched controls were included. The median overall costs of a CABG case were 36,261 Euro compared with 13,356 Euro per control patient without infection (p<0.0001). The median overall LOS was 34.4 days versus 16.5 days, respectively (p=0.0006). The median LOS on ICU was 6.3 days versus 5.3 days (no significant difference). DSWI represents an important economic factor for the hospital as they may almost triple the costs for patients undergoing CABG. Thus, appropriate infection control measures for the prevention of DSWI should be enforced. |
Author | Haverich, Axel Graf, Karolin Vonberg, Ralf-Peter Ott, Ella Kuehn, Christian Chaberny, Iris Freya |
Author_xml | – sequence: 1 givenname: Karolin surname: Graf fullname: Graf, Karolin email: Graf.Karolin@MH-Hannover.DE organization: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany – sequence: 2 givenname: Ella surname: Ott fullname: Ott, Ella organization: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany – sequence: 3 givenname: Ralf-Peter surname: Vonberg fullname: Vonberg, Ralf-Peter organization: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany – sequence: 4 givenname: Christian surname: Kuehn fullname: Kuehn, Christian organization: Department for Cardiac, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany – sequence: 5 givenname: Axel surname: Haverich fullname: Haverich, Axel organization: Department for Cardiac, Thoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany – sequence: 6 givenname: Iris Freya surname: Chaberny fullname: Chaberny, Iris Freya organization: Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany |
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Copyright | European Association for Cardio-Thoracic Surgery © 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. 2009 2015 INIST-CNRS Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. |
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Keywords | Costs Reimbursement Coronary artery bypass Length of stay Sternum Cardiovascular disease Coronary heart disease Wound Infection Length Circulatory system Economic aspect Cardiology Pneumology |
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Snippet | Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG)... Abstract Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting... Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may... OBJECTIVESSurgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG)... |
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SubjectTerms | Aged Biological and medical sciences Cardiology. Vascular system Comorbidity Coronary artery bypass Coronary Artery Bypass - economics Coronary heart disease Costs Epidemiologic Methods Female Germany Heart Hospital Costs - statistics & numerical data Humans Insurance, Health, Reimbursement - statistics & numerical data Intensive Care Units - economics Length of stay Length of Stay - statistics & numerical data Male Medical sciences Pneumology Reimbursement Sternum - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Surgical Wound Infection - economics Surgical Wound Infection - therapy |
Title | Economic aspects of deep sternal wound infections |
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