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Surgical-Site Infection Due to Staphylococcus aureus Among Elderly Patients Mortality, Duration of Hospitalization, and Cost

Published online by Cambridge University Press:  02 January 2015

Sarah A. McGarry
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina
John J. Engemann
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina
Kenneth Schmader
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina Center for the Study of Aging and Human Development, Duke University Medical Center, and the General Research Education & Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina
Keith S. Kaye*
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina
*
Box 3152, Division of Infectious Disease, Duke University Medical Center, Durham, NC 27710

Abstract

Objectives:

To examine the impact of surgical-site infection (SSI) due to Staphylococcus aureus on mortality, duration of hospitalization, and hospital charges among elderly surgical patients and the impact of older age on these outcomes by comparing older and younger patients with S. aureus SSI.

Design:

A nested cohort study.

Setting:

A 750-bed, tertiary-care hospital and a 350-bed community hospital.

Patients:

Ninety-six elderly patients (70 years and older) with S. aureus SSI were compared with 2 reference groups: 59 uninfected elderly patients and 131 younger patients with S. aureus SSI.

Results:

Compared with uninfected elderly patients, elderly patients with S. aureus SSI were at risk for increased mortality (odds ratio [OR], 5.4; 95% confidence interval [CI95], 1.5-20.1), postoperative hospital-days (2.5-fold increase; CI95, 2.0-3.1), and hospital charges (2.0-fold increase; CI95, 1.7-2.4; $41,117 mean attributable charges per SSI). Compared with younger patients with S. aureus SSI, elderly patients had increased mortality (adjusted OR, 2.9; CI95, 1.1-7.6), hospital-days (9 vs 13 days; P = .001), and median hospital charges ($45,767 vs $85,648; P < .001).

Conclusions:

Among elderly surgical patients, S. aureus SSI was independently associated with increased mortality, hospital-days, and cost. In addition, being at least 70 years old was a predictor of death in patients with S. aureus SSI.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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