158 A Nationwide Analysis of Cost Variation for Cerebral Aneurysm Treatment

Yoon, James S; Yoon, Chaewon; Winkler, Ethan A.; Liu, Caterina; Torok, Ildiko; Lawton, Michael T.

doi:10.1093/neuros/nyy303.158

Cited by 1 publication

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“…The Vizient dataset has been used in a range of studies for evaluation of cost and outcome for several hospital based therapies. 19 –23…”

Section: Methodsmentioning

confidence: 99%

“…The Vizient dataset has been used in a range of studies for evaluation of cost and outcome for several hospital based therapies. [19][20][21][22][23] Vizient also calculates a severity-of-illness score for diagnosis related codes, which accounts for demographic variables, hospital diagnoses, and comorbid conditions that were present upon hospital admission. The database uses regression models to predict expected length of stay (LOS), mortality outcomes for all inpatient discharges in the database.…”

Section: Cost and Outcome Measuresmentioning

confidence: 99%

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Prevalence and Outcomes of Multi-Drug Resistant Blood Stream Infections Among Nursing Home Residents Admitted to an Acute Care Hospital

Aliyu

McGowan

Hussain

et al. 2021

J Intensive Care Med

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Objective: The prevalence of multi-drug resistant organism (MDRO) colonization in nursing home residents has been well documented, but little is known about the impact of MDRO bloodstream infections (BSIs). The aim of this study was to assess the prevalence, cost, and outcomes of MDRO-BSI vs. non-MDRO-BSI among nursing home residents. Design: Retrospective cohort study Setting: 960 bed tertiary academic medical center Patients: Persons ≥18 years old admitted to an acute care tertiary hospital from Skilled Nursing Facilities with a diagnosis of sepsis between 2015 and 2018. Interventions: Retrospective analysis of prevalence and outcomes. Measurements and Main Results: Among patients admitted to the study hospital with a diagnosis of sepsis during the study period, 7% were from nursing homes. The prevalence of MDRO-BSI was 47%. We identified 54 (50%) gram positive BSIs, 48 (45%) gram negative BSI and 5 (5%) fungal BSI. Thirty-one (57%) of the gram-positive infections and 14 (30%) of the gram-negative infections were with MDROs. The prevalence of BSI organisms were Staphylococcus aureus in 24%, Escherichia coli in 14%, Proteus mirabilis in 13%, Staphylococcus epidermidis in 8%, Enterococcus faecalis in 7%, and Klebsiella pneumoniae in 6%. We found that intensive care unit length of stay (7 days vs 5 days, P = .009), direct cost ($13,639 vs $9,922, P = .027), and total cost ($23,752 vs $17,900 P = .032) were significantly higher in patients with MDRO-BSI vs. non-MDRO-BSI. Patients with MDRO-BSI were twice as likely to receive inappropriate empiric antiinfective therapy (31% vs 16%, P = .006) and were more likely to die (49.1% vs 29.6%, P = .049). Conclusion: Nursing home residents have a high prevalence of MDRO-BSI, which is associated with higher risk of receiving inappropriate initial anti-infective therapy, higher cost, higher ICU LOS, and higher mortality. Our research adds new information about the prevalence of fungemia in this population.

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“…The Vizient dataset has been used in a range of studies for evaluation of cost and outcome for several hospital based therapies. 19 –23…”

Section: Methodsmentioning

confidence: 99%