Mortality, long-term disability, and medical expenditure: methicillin-resistant versus methicillin-sensitive Staphylococcus aureus bacteremia
| Autor: | Chun-Chun Yeh, 葉竹君 |
|---|---|
| Rok vydání: | 2019 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 107 Background and purpose：Hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) is associated with an excess mortality, prolonged hospital stay, and extra medical cost, compared with hospital-acquired methicillin-sensitive S. aureus (MSSA) BSI. The aims of our study to compare the risk of new-onset long-term hemodialysis and ventilator dependence between MRSA BSI and MSSA BSI. Method：This is a retrospective cohort study of all inpatients had healthcare-associated infections (HAI) with S. aureus BSIs at Taichung Veterans General Hospital (Taichung, Taiwan), between 1 January 2010 and 31 December 2017. We compared MSSA and MRSA BSIs for medical cost, mortality, new-onset long-term hemodialysis and new-onset ventilator dependence. We used Cox proportional hazard regression to adjust for the effects of confounding factors. Result：There were 147 MRSA BSIs and 81 MSSA BSIs during the study period. The mean medical expenditure were NT$570,555 for MRSA and NT$348,887 for MSSA (p=0.001). In comparison with patients with MSSA BSI, patients with MRSI BSI had an increase in risk of mortality (hazard ratio [HR] 1.67, 95% CI 0.94-2.95), new-onset dialysis-dependence (HR 1.64, 95% CI 0.38-7.14) and new-onset ventilator dependence (HR 1.32, 95% CI 0.26-6.73) after adjusting for severity of sepsis and the comorbidities. Conclusion：Patients with MRSA BSI tend to have poorer outcomes, in term of both acute mortality and chronic dialysis/ventilator-dependence. Our results highlight the importance of hospital-acquired MRSA infection control. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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