Healthcare News & Insights

Study: Hospital mortality rates up in ICU patients with HAI

A recent analysis of an American hospital database found that in-hospital mortality in ICU patients with hospital-acquired infections (HAI) is four times higher (18.5% vs. 4.5%) than those without. But that’s not all it found.

Length of stay for these patients in the ICU doubled from a mean of 8.1 days to 15.8 days.

Two factors that increased patients’ risk for an HAI: coming from the emergency department and being over 75 years old.

So which infections were more likely to drive up the mortality rate?

  • Bloodstream infection (24.7%)
  • Hospital-acquired pneumonia (16.7%), and
  • Surgical-site infection (10.9%).

The Premier Perspective hospital database, which was analyzed for the study, covered 20% of U.S. hospital discharges – 460,000 ICU patients. The study looked at patients over 18 with an ICU stay of at least 48 hours in 2007. Note: The researchers also looked at data from 2008 and 2009 and got similar results.

Cost analysis

What will really interest hospital executives is what the study found when it did a cost analysis based on direct variable costs and fixed overhead costs:

The infections cost an extra $16,000 per ICU stay, noted Florence Joly, PharmD,  from global evidence and value development at Sanofi in Paris, France, and lead researcher of the study. For a patient without an HAI, the cost was $21,500. For a patient with an HAI, the cost was $37,500.

Kenneth Christopher, MD, from Brigham and Women’s Hospital, Harvard Medical School, Boston, offered a word of caution concerning the study results. He noted that 25.8% of ICU patients who developed an HAI in the study were more likely to have a predisposition to infection-related supportive measures, such as endotracheal tube placement and intravascular lines.

He also pointed to a study the Centers for Disease Control and Prevention (CDC) published in 2011 on ICUs in the United States, which showed that from 2001 to 2009, central-line-associated bloodstream infection dropped 58%. The CDC report also found that the initiation of a bundle protocol was an effective method to reduce ventilator-acquired pneumonia.

So while many U.S. hospitals already have infection control practices implemented for critically ill patients and infection rates are down, it still poses a major threat to patients and a huge financial burden to hospitals.

Do you feel U.S. facilities’ practices to prevent HAI in the ICU are enough or can even more be done? Share your thoughts below.

 

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