Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost.
J Crit Care
; 20(1): 46-58, 2005 Mar.
Article
en En
| MEDLINE
| ID: mdl-16015516
ABSTRACT
PURPOSE:
Severe sepsis is a leading cause of death in critically ill patients. We evaluated cost and workload according to infection site, place and time of acquisition, and severity. MATERIAL ANDMETHOD:
We used a prospective 3-year database from 6 intensive care units (ICUs) including 1698 patients.RESULTS:
Of the 1698 patients, 713 (42%) had severe sepsis at admission and 339 during the ICU stay (211 had both). Mortality was twice as high in patients with than those without ICU-acquired infection, independent of the presence of severe sepsis at admission. The mean (SD; median) cost of severe sepsis was 22 800 (21 400 ; 15 800 ). Among patients with severe sepsis at admission, workload and cost were higher for pneumonia, peritonitis, and multiple-site infections and for hospital-acquired (17,400 [14,700; 17,400]) vs community-acquired infection (12,600 [12,100 ; 8900 ]). Intensive care unit-acquired severe sepsis was associated with greater than 3-fold increases in workload and costs. By multiple linear regression, older age, emergency surgery, septic shock, Acute Physiological and Chronic Health Evaluation II score, and hospital or ICU-acquired severe sepsis were independently associated with higher costs.CONCLUSIONS:
The wide variations in cost and workload invite efforts to identify patient subgroups most likely to benefit from high-cost treatments and from prevention, particularly targeting severe nosocomial infections.
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Banco de datos:
MEDLINE
Asunto principal:
Costos de la Atención en Salud
/
Síndrome de Respuesta Inflamatoria Sistémica
/
Unidades de Cuidados Intensivos
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2005
Tipo del documento:
Article