Skip to main content
Top
Published in: Infection 1/2014

01-02-2014 | Clinical and Epidemiological Study

Costs and prolonged length of stay of central venous catheter-associated bloodstream infections (CVC BSI): a matched prospective cohort study

Authors: R. Leistner, E. Hirsemann, A. Bloch, P. Gastmeier, C. Geffers

Published in: Infection | Issue 1/2014

Login to get access

Abstract

Purpose

Central venous catheter-associated bloodstream infections (CVC BSI) are a common and serious complication among critically ill patients on intensive care units (ICUs), but also result in a financial burden for the health care system. Our aim was to determine the additional costs and length of stay (LOS) of patients with ICU-acquired CVC BSI.

Methods

We used the surveillance method of the German nosocomial infection surveillance system (Krankenhaus Infections Surveillance System, KISS) to find cases of CVC BSI. The associated costs of CVC BSI were estimated as true costs generated within our hospital. We used a matched cohort design, comparing patients with CVC BSI and patients without BSI. The study period was from January to December 2010. Patients were matched by age, sex, and Simplified Acute Physiology Score (SAPS). The LOS in the ICU of control patients needed to be at least as long as that of CVC BSI patients before the onset of CVC BSI.

Results

We matched 40 CVC BSI patients to 40 patients without BSI. The median hospital costs for CVC BSI patients were significantly higher than for patients without BSI (60,445 € vs. 35,730 €; p = 0.006) and the CVC BSI patients stayed longer in the hospital than patients without CVC BSI (44 days vs. 30 days; p = 0.110). The median attributable costs per CVC BSI was 29,909 € (p = 0.006) and the median attributable LOS was 7 days (p = 0.006).

Conclusion

CVC BSI is associated with increased hospital costs and prolonged hospital stay. Hospital management should implement control measurements to keep the incidence of CVC BSI as low as possible.
Literature
1.
2.
go back to reference Blot SI, Depuydt P, Annemans L, Benoit D, Hoste E, De Waele JJ, et al. Clinical and economic outcomes in critically ill patients with nosocomial catheter-related bloodstream infections. Clin Infect Dis. 2005;41:1591–8. doi:10.1086/497833.PubMedCrossRef Blot SI, Depuydt P, Annemans L, Benoit D, Hoste E, De Waele JJ, et al. Clinical and economic outcomes in critically ill patients with nosocomial catheter-related bloodstream infections. Clin Infect Dis. 2005;41:1591–8. doi:10.​1086/​497833.PubMedCrossRef
6.
go back to reference Vrijens F, Hulstaert F, Van de Sande S, Devriese S, Morales I, Parmentier Y. Hospital-acquired, laboratory-confirmed bloodstream infections: linking national surveillance data to clinical and financial hospital data to estimate increased length of stay and healthcare costs. J Hosp Infect. 2010;75:158–62. doi:10.1016/j.jhin.2009.12.006.PubMedCrossRef Vrijens F, Hulstaert F, Van de Sande S, Devriese S, Morales I, Parmentier Y. Hospital-acquired, laboratory-confirmed bloodstream infections: linking national surveillance data to clinical and financial hospital data to estimate increased length of stay and healthcare costs. J Hosp Infect. 2010;75:158–62. doi:10.​1016/​j.​jhin.​2009.​12.​006.PubMedCrossRef
7.
go back to reference Digiovine B, Chenoweth C, Watts C, Higgins M. The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med. 1999;160:976–81.PubMedCrossRef Digiovine B, Chenoweth C, Watts C, Higgins M. The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med. 1999;160:976–81.PubMedCrossRef
8.
go back to reference Higuera F, Rangel-Frausto MS, Rosenthal VD, Soto JM, Castañon J, Franco G, et al. 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. Infect Control Hosp Epidemiol. 2007;28:31–5. doi:10.1086/510812.PubMedCrossRef Higuera F, Rangel-Frausto MS, Rosenthal VD, Soto JM, Castañon J, Franco G, et al. 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. Infect Control Hosp Epidemiol. 2007;28:31–5. doi:10.​1086/​510812.PubMedCrossRef
9.
go back to reference Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1994;271:1598–601.PubMedCrossRef Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1994;271:1598–601.PubMedCrossRef
10.
go back to reference Zuschneid I, Rücker G, Schoop R, Beyersmann J, Schumacher M, Geffers C, et al. Representativeness of the surveillance data in the intensive care unit component of the German nosocomial infections surveillance system. Infect Control Hosp Epidemiol. 2010;31:934–8. doi:10.1086/655462.PubMedCrossRef Zuschneid I, Rücker G, Schoop R, Beyersmann J, Schumacher M, Geffers C, et al. Representativeness of the surveillance data in the intensive care unit component of the German nosocomial infections surveillance system. Infect Control Hosp Epidemiol. 2010;31:934–8. doi:10.​1086/​655462.PubMedCrossRef
11.
go back to reference Gastmeier P, Geffers C, Sohr D, Dettenkofer M, Daschner F, Rüden H. Five years working with the German nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System). Am J Infect Control. 2003;31:316–21. doi:10.1067/mic.2003.66.PubMedCrossRef Gastmeier P, Geffers C, Sohr D, Dettenkofer M, Daschner F, Rüden H. Five years working with the German nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System). Am J Infect Control. 2003;31:316–21. doi:10.​1067/​mic.​2003.​66.PubMedCrossRef
13.
go back to reference Krause R, Valentin T, Salzer H, Hönigl M, Valentin A, Auner H, et al. Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters? Infection. 2013;41:49–52.PubMedCrossRef Krause R, Valentin T, Salzer H, Hönigl M, Valentin A, Auner H, et al. Which lumen is the source of catheter-related bloodstream infection in patients with multi-lumen central venous catheters? Infection. 2013;41:49–52.PubMedCrossRef
15.
go back to reference Graves N, Barnett AG, Halton K, Crnich C, Cooper B, Beyersmann J, et al. The importance of good data, analysis, and interpretation for showing the economics of reducing healthcare-associated infection. Infect Control Hosp Epidemiol. 2011;32:927–8. doi:10.1086/661600 (author reply 8–30).PubMedCrossRef Graves N, Barnett AG, Halton K, Crnich C, Cooper B, Beyersmann J, et al. The importance of good data, analysis, and interpretation for showing the economics of reducing healthcare-associated infection. Infect Control Hosp Epidemiol. 2011;32:927–8. doi:10.​1086/​661600 (author reply 8–30).PubMedCrossRef
16.
go back to reference Tacconelli E, Smith G, Hieke K, Lafuma A, Bastide P. Epidemiology, medical outcomes and costs of catheter-related bloodstream infections in intensive care units of four European countries: literature- and registry-based estimates. J Hosp Infect. 2009;72:97–103. doi:10.1016/j.jhin.2008.12.012.PubMedCrossRef Tacconelli E, Smith G, Hieke K, Lafuma A, Bastide P. Epidemiology, medical outcomes and costs of catheter-related bloodstream infections in intensive care units of four European countries: literature- and registry-based estimates. J Hosp Infect. 2009;72:97–103. doi:10.​1016/​j.​jhin.​2008.​12.​012.PubMedCrossRef
18.
go back to reference Rosenthal VD, Guzman S, Migone O, Crnich CJ. The attributable cost, length of hospital stay, and mortality of central line-associated bloodstream infection in intensive care departments in Argentina: a prospective, matched analysis. Am J Infect Control. 2003;31:475–80. doi:10.1016/j.ajic.2003.03.002.PubMedCrossRef Rosenthal VD, Guzman S, Migone O, Crnich CJ. The attributable cost, length of hospital stay, and mortality of central line-associated bloodstream infection in intensive care departments in Argentina: a prospective, matched analysis. Am J Infect Control. 2003;31:475–80. doi:10.​1016/​j.​ajic.​2003.​03.​002.PubMedCrossRef
19.
go back to reference Orsi GB, Di Stefano L, Noah N. Hospital-acquired, laboratory-confirmed bloodstream infection: increased hospital stay and direct costs. Infect Control Hosp Epidemiol. 2002;23:190–7. doi:10.1086/502034.PubMedCrossRef Orsi GB, Di Stefano L, Noah N. Hospital-acquired, laboratory-confirmed bloodstream infection: increased hospital stay and direct costs. Infect Control Hosp Epidemiol. 2002;23:190–7. doi:10.​1086/​502034.PubMedCrossRef
Metadata
Title
Costs and prolonged length of stay of central venous catheter-associated bloodstream infections (CVC BSI): a matched prospective cohort study
Authors
R. Leistner
E. Hirsemann
A. Bloch
P. Gastmeier
C. Geffers
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 1/2014
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-013-0494-z

Other articles of this Issue 1/2014

Infection 1/2014 Go to the issue

Images in Infection

Cytomegalovirus oral ulcers

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.