摘要
目的分析心脏外科手术部位感染(SSI)造成的直接经济损失,为采取干预措施提供循证学依据。方法采用病例对照研究的方法,回顾性收集2015年1月1日-2019年12月31日天津市胸科医院心脏外科手术患者性别、年龄、术式、手术时间等基本信息,将发生SSI患者90例纳入SSI组,其余患者采用倾向评分匹配法与SSI组患者进行1∶1匹配,匹配后的90例患者纳入对照组,分别比较两组患者间以及不同类型SSI患者之间的住院天数和各项住院费用。结果 SSI组表浅SSI 41例,深部SSI 34例,器官/腔隙感染15例。三类患者总住院费用、药品费、医用材料费和输血费差异有统计学意义(P<0.05),均为器官/腔隙感染最高。SSI组较对照组延长住院天数31.5 d(Z=-10.800,P<0.001),增加总住院费用90 417.00元(Z=-8.288,P<0.001),其中药品费、治疗费和医用材料费增加最多。表浅SSI、深部SSI、器官/腔隙感染分别延长住院天数35.00 d、27.00 d和45.00 d,增加总住院费用69 191.25元、82 318.30元和241 646.80元,差异均有统计学意义(P<0.001)。结论心脏外科患者术后SSI的发生会延长患者住院天数,为患者和医院带来巨大的经济损失。有效控制医院感染对于优化医疗资源、提升医疗质量、保障患者安全有着重要的意义。
OBJECTIVE To analyze the direct economic losses due to surgical site infection(SSI) in the cardiac surgery patients so as to provide evidence-based basis for taking intervention measures. METHODS A case-control study was conducted to retrospectively collect the data of the patients who underwent cardiac surgery in Tianjin Chest Hospital from Jan. 1,2015 to Dec. 31, 2019, including gender, age, operation mode and operation duration. Totally 90 patients with SSI were assigned as the SSI group, the rest of the patients were matched with the SSI group in a 1∶1 ratio by using propensity score matching method, and 90 matched patients were assigned as the control group. The length of hospital stay and hospitalization costs were observed and compared between the two groups of patients and among the patients with different types of SSI. RESULTS There were 41 cases of superficial SSI, 34 cases of deep SSI and 15 cases of organ/lacunar infection in the SSI group. There were significant differences in total hospitalization cost, cost of drugs, cost of medical materials and cost of blood transfusion among the three groups of patients(P<0.05), and the proportion of the patients with organ/lacunar infection was the highest. The length of hospital stay of the SSI group was 31.5 days longer than that of the control group(Z=-10.800,P<0.001), the total hospitalization cost was increased by 90 417.00 yuan(Z=-8.288,P<0.001), among which the costs of drugs, treatment and medical material were increased the most. The lengths of hospital stay of the patients with superficial SSI, deep SSI and organ/lacunar infection were respectively extended by 35.00, 27.00 and 45.00 days;the total hospitalization costs were respectively increased by 69 191.25, 82 318.30 and 241 646.80 yuan, and there were significant differences(P<0.001). CONCLUSION The postoperative SSI in the cardiac surgery patients may extend the length of hospital stay and lead to tremendous economic loss. It is of great significance to effectively control the nosocomial infect
作者
吴雪
吴迪
徐珊
褚玉晶
黄玲玉
李冠华
WU Xue;WU Di;XU Shan;CHU Yu-jing;HUANG Ling-yu;LI Guan-hua(Tianjin Chest Hospital,Tianjin 300222,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第4期560-564,共5页
Chinese Journal of Nosocomiology
基金
天津市科技发展战略研究计划基金资助项目(19ZLZXZF00340)
天津市医院协会医院管理研究基金资助项目(2018zz07)。
关键词
心脏外科
手术部位感染
直接经济损失
Cardiac surgery
Surgical site infection
Direct economic loss
