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Attributable Cost and Length of Stay for Patients With Central Venous Catheter—Associated Bloodstream Infection in Mexico City Intensive Care Units A Prospective, Matched Analysis

Published online by Cambridge University Press:  02 January 2015

Francisco Higuera
Affiliation:
General Hospital, Mexico City, Mexico
Manuel Sigfrido Rangel-Frausto
Affiliation:
Specialties Instituto Mexicano del Seguro Social Hospital, Mexico City, Mexico
Victor Daniel Rosenthal*
Affiliation:
Medical College of Buenos Aires, Buenos Aires, Argentina
Jose Martinez Soto
Affiliation:
Gabriel Mancera IMSS Hospital, Mexico City, Mexico
Jorge Castañon
Affiliation:
Specialties Instituto Mexicano del Seguro Social Hospital, Mexico City, Mexico
Guillermo Franco
Affiliation:
General Hospital, Mexico City, Mexico
Natividad Tabal-Galan
Affiliation:
Specialties Instituto Mexicano del Seguro Social Hospital, Mexico City, Mexico
Javier Ruiz
Affiliation:
General Hospital, Mexico City, Mexico
Pablo Duarte
Affiliation:
General Hospital, Mexico City, Mexico
Nicholas Graves
Affiliation:
School of Public Health, Queensland University of Technology, Queensland, Australia
*
Medical College of Buenos Aires, Arengreen 1366, Buenos Aires, 1405, Argentina ([email protected])

Abstract

Background.

No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico.

Objective.

To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City.

Design.

An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI.

Setting.

Adult ICUs in 3 hospitals in Mexico City.

Patients and Methods.

A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments.

Results.

For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was $598, the mean extra hospital cost was $11,591, and the attributable extra mortality was 20%.

Conclusions.

In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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