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Vol. 22. Num. 6.January 2011
Pages 488-607
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Vol. 22. Num. 6.January 2011
Pages 488-607
DOI: 10.1016/S1130-1473(11)70108-7
Clinical and economic analysis of hospital acquired infections in patients diagnosed with brain tumor in a tertiary hospital
Análisis clínico económico de las infecciones nosocomiales en los pacientes diagnosticados de tumoración cerebral en un hospital terciario
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J. Undabeitia??
Corresponding author
Department of Neurosurgery. Arnau Hospital. Villanova. Lleida
B.G. Liu**, G. Catalán*,***, G. Bilbao*,***, I. Pomposo*,***, J.M. Garibi*,***
* Department of Neurosurgery. Cruces Hospital. University of the Basque Country
** Department of Neurosurgery. Johns Hopkins Medical Institutions. University of the Basque Country
*** Department of Surgery. University of the Basque Country
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Summary
Objectives

To analyze the relationship between hospital acquired infections and clinical outcomes, duration of stay, and cost per infectious episode in patients diagnosed with brain tumors in our service.

Materials and methods

We conducted a retrospective study on patients diagnosed with brain tumors and admitted to the department of neurosurgery in the Cruces Hospital of the University of the Basque Country between January 1st, 2007 and December 31st, 2007. We collected demographics, responsible pathogens, infection location, length of hospitalization, and costs of various medical and surgical procedures performed.

Results

We reviewed 139 patients that accumulated 210 hospital visits. We found 34 episodes of hospital acquired infections (16.25% of patients). The most frequent infections were that of the lower respiratory tract, urinary tract, and surgical site. We found that patients with HAIs had a significantly lower final KPS score (sig <0.01), greater mean cost of stay (17097€, sig.<0.01), and longer length of stay (15.45 days, sig<0.01). We did not find a significant difference in mortality.

Conclusions

We found significant association between the presence of HAIs and worse clinical outcomes, higher costs, and longer length of stay. The pathogens responsible and infection locations were similar to existing series in the literature. Although variability in study designs in the literature makes interpretation and comparison of results difficult, measures to prevent these complications can improve quality of care and reduce costs.

Key words:
Brain neoplasms
Infection
Costs
Abreviations:
HAI
ICU
KPS
LOS
SD
Resumen
Objetivos

Analizar la relación entre la presencia de infección nosocomial y el resultado clínico final, la duración de la estancia y el coste del episodio en los pacientes diagnosticados de tumoración cerebral en nuestro servicio.

Material y método

Realizamos un estudio retrospectivo incluyendo los pacientes ingresados en el Servicio de Neurocirugía del Hospital Universitario de Cruces con diagnostico de tumoración cerebral en el periodo comprendido entre el 1-1-2007 y el 31-12 del 2007. Recogimos variables demográficas, los microorganismos responsables y la localización de las distintas infecciones, el tiempo de ingreso y los costes de los distintos procedimientos médicos y quirúrgicos realizados.

Resultados

Recogimos 139 pacientes, que acumularon un total de 210 episodios. Encontramos la presencia de infecciones nosocomiales en 34 episodios (16,25%). La localización mas frecuente fue la respiratoria, seguida del tracto urinario y la infección de herida quirúrgica. Encontramos unas diferencias significativas en la situación funcional al alta (sig <0.01), el coste medio de los episodios (17097€, sig.<0.01) y en la estancia media (15.45 días, sig.<0.01). No encontramos diferencias significativas con respecto a la mortalidad.

Conclusiones

Encontramos asociaciones significativas entre la presencia de infección nosocomial, un peor resultado clínico, un mayor coste y una mayor estancia. Los gérmenes responsables y localizaciones fueron similares a las series previamente publicadas. A pesar de que la variabilidad en el diseño de los estudios recogidos en la literatura dificulta la interpretación y comparación de los resultados, las medidas destinadas a la prevención de esta complicación permiten simultáneamente mejorar la asistencia prestada, asi como reducir los costes generados por la enfermedad.

Palabras clave:
Tumor cerebral
Infección
Costes

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