儿科脑外伤患者发生院内感染的风险因素和成本。

Northern clinics of Istanbul Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI:10.14744/nci.2023.26037
Feyza Incekoy Girgian, Makbule Nilufer Ozturk
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引用次数: 0

摘要

目的:本研究旨在确定增加小儿脑外伤患者院内感染(NIs)的因素以及对治疗费用和住院时间的影响:本研究旨在确定增加儿科脑外伤(TBI)患者院内感染(NIs)的因素及其对治疗费用和住院时间的影响:我们对2012年至2014年期间入住儿科重症监护室(PICU)的创伤性脑损伤患者(66人)或非创伤性脑损伤患者(120人)进行了病例对照研究。研究确定了非创伤性住院的风险因素、住院时间和费用:分析了 186 名患者的数据。其中 120 名患者为对照组(54 名男性,66 名女性),66 名患者为病例组(27 名男性,39 名女性)。在 186 名 PICU 患者中,有 17 人患有 NI。约 7.6% 的创伤性脑损伤患者有感染,而 10% 的对照组有 NIs(P=0.58)。分离出最多的微生物病原体是鲍曼不动杆菌(4 例)。17 例感染中有 13 例(76.5%)为导管相关血流感染。每名重症监护病房患者的平均费用为 762 美元,受到院内污染的患者的额外费用为 2081 美元:结论:在我们的研究中,导管的使用是导致非病菌感染的最关键风险因素,这可能是低估成本的几个原因。尽管如此,研究结果还是支持了我们的假设,即非病原菌传播会给 PICU 患者带来额外负担。这项研究的结果将有助于为成本效益提供证据,或计算减少儿童 NI 的成本效益比。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors and cost of nosocomial infections in pediatric patients with traumatic brain injury.

Objective: This study aimed to determine the factors that increase nosocomial infections (NIs) in pediatric patients with traumatic brain injury (TBI) and the effects on both treatment cost and length of hospital stay.

Methods: We performed a case-control study on patients admitted to the pediatric intensive care unit (PICU) with (n=66) or without (n=120) TBI between 2012 and 2014. The risk factors, length of stay, and costs of NIs were determined.

Results: Data for 186 patients were analyzed. One hundred and twenty patients were controls (54 males vs. 66 females), while 66 were cases (27 males vs. 39 females). Seventeen out of the 186 PICU patients had NIs. About 7.6% of TBI patients had infections whereas 10% of control groups had NIs (p=0.58). The most isolated microbial agent was Acinetobacterbaumannii (four cases). Thirteen (76.5%) out of the 17 infections were catheter-related bloodstream infections. The mean expenses per PICU patient were $762, with an additional cost of $2081 for patients with nosocomial contamination.

Conclusion: The use of catheters was the most critical risk factor for NIs in our study probably underestimated the cost for several reasons. Nevertheless, the findings supported our hypothesis about the additional burden of nosocomial spread on PICU patients. This study's results should help provide evidence on cost-effectiveness or calculate the cost-benefit ratio of reducing NIs in children.

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