Costs Associated With Health Care–Associated Infections in Cardiac Surgery | Journal Scan

Study Questions:

In the first 2 months following cardiac surgery, what is the cost associated with health care–associated infections (HAIs)?

Methods:

This was a prospective, multicenter, observational study conducted between February 2010 and October 2010. Clinical data were linked to patient-level economic data obtained from the University HealthSystem Consortium. Incremental hospital length of stay (LOS) and infection cost were the study endpoints; direct hospital costs were calculated for the index hospitalization and for readmissions.

Results:

Including the index hospitalization and readmissions, 250 major HAIs developed in 194 patients (4.5% of the cohort). Pneumonia was the most common HAI (48%), followed by bloodstream, Clostridium difficile, and surgical site infections. Fifteen percent of index hospitalizations were associated with a readmission within 30 days, and the reason for readmission was ascribed to HAIs in 9.1% of these patients. The estimated incremental cost associated with a major HAI, on average, was nearly $38,000. The incremental LOS was 14 days.

Conclusions:

HAIs complicating cardiac surgery are associated with increased LOS and resource utilization, and account for a significant proportion of readmissions within 30 days.

Perspective:

This is an important analysis that draws attention to the significant economic burden of HAIs, which account for the most common noncardiac complication following cardiac surgery. The limitations of this study aside, the authors draw attention to the need for continued quality improvement efforts to reduce the risk of HAIs following cardiac surgery.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention

Keywords: Cardiac Surgical Procedures, Clostridium difficile, Communicable Diseases, Cost of Illness, Health Resources, Hospital Costs, Hospitalization, Length of Stay, Patient Readmission, Pneumonia, Quality Improvement


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