Factores de riesgo y coste económico de la infección nosocomial en un hospital de ámbito comarcal

Abstract

Study Objective: 1) descriptive study of the nosocomial infection (NI) episodes in the Sant Jaume of Calella hospital during 2 years; 2) study of the risk factors (RF) of the thre NI more frequents, the site surgical infection (SSI), the urinary tract infection (UTI) and the nosocomial pneumonia (NP) in a hospital of less than 200 beds and 3) To evaluate the economic cost of NI by two methods, by calculation of cost resulting from increase of hospital stay attributable to NI and by calculation of cost attributed to services and procedures. Patients and method: A matched case-control prospective study with a cohort population. The matched was 1:1 for the SSI and the UTI and was 1:4 for the NP. To evaluate the RF the control were matched for sex, age and date of admission in the hospital. Both univariate and multivariate analysis were performed using the logistic regresion method.To evaluate the economic cost, the controls were matched for sex, principal diagnosis, surgical procedure, age and date of admission. A test of Wilcoxon was practiced. Results: There were 408 episodes of NI, with an incidence of the 3.06%. The RF associated were: a) for de SSI: emergency surgical, abdominal surgery, inadecuate surgical prophylaxis, previous admission and days of stay in the hospital; b) for the UTI: urinary catheter and c) for the NP: nasogastric tube, immunosupression, stroke and days of admission in the hospital. We compared of costs between cases and controls by two methods: 1) calculation of cost resulting from an increase of hospital stay attributable to NI and 2) calculation of costs attributed to services or procedures. Conclusions: Accurated prophylactic methods, specially in modificable factors, would ameliorate the incidence of NI and then improve the morbility and mortality results, but also would disminish the cost generated, calculated both by the increase of hospital stay or by the costs attributed to services.

Date of Award	29 May 2001
Original language	Undefined/Unknown
Supervisor	Josep Antoni Capdevila Morell (Director) & Albert Pahissa Berga (Director)