Added Hospital Stay Due to Wound Infections Following Cardiac Surgery

Kappstein, Ines; Schulgen, Gabi; Fraedrich, Gustav; Schlosser, V.; Schumacher, Martin; Daschner, Franz

doi:10.1055/s-2007-1020134

Cited by 46 publications

(22 citation statements)

References 2 publications

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“…The study provided complex information on the excess cost due to NP not available from previous studies with similar aims [11,15,[21][22][23][24][25][26][27]. In addition, the total expenses for the hospital were compared to the cost reimbursed by statutory insurance funds.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Pneumonia: A Cost-of-Illness Analysis

et al. 2002

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The study gives insight into the structure of incremental cost caused by NP and shows that based on a conservative cost calculation the incremental cost per NP patient is higher for the hospital than for health insurance funds which indicates a significant financial deficit for the hospital. Antibiotics and microbiology together only contribute 6.8% to incremental cost. Therefore in a cost saving initiative their close relationship to length of hospitalization must be considered.

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Section: Discussionmentioning

confidence: 99%

Nosocomial Pneumonia: A Cost-of-Illness Analysis

et al. 2002

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“…Some cases require further surgery, including repeated debridement and major surgical reconstruction. There is almost invariably considerable increase in the length of hospital stay [5], and the incidence of further complications is high. Patients who develop sternal wound infection have an inpatient mortality of 14% (normally about 2%), a threefold increase in mortality over the first 4 years after surgery and a significantly higher short term and long-term morbidity [6].…”

Section: Sternal Wound Infectionmentioning

confidence: 99%

The role of hyperbaric oxygen therapy in the treatment of sternal wound infection

Mills

Bryson²

2006

European Journal of Cardio-Thoracic Surgery

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Sternal wound dehiscence and infection are major problems for patients and health care providers. A range of risk factors, including diabetes, obesity and internal thoracic artery harvest, has been implicated. Several pathophysiological mechanisms, which may account for the development of infection, have been proposed. There is a growing body of evidence which suggests that sternal ischaemia may play a significant role in the initiation of wound infection, and that this may be exacerbated by harvest of the internal thoracic artery. Current treatments for infection include wound debridement, irrigation and tissue flap reconstruction. In addition, several novel therapies such as negative pressure dressings have been shown to be safe and useful. Hyperbaric oxygen therapy - the administration of 100% oxygen at pressures greater than atmospheric pressure - is widely used in the treatment of various chronic wounds. The mechanism whereby hyperbaric oxygen exerts its effects is being elucidated and there is a growing body of clinical evidence that supports its use. It has been suggested that there may be a role for hyperbaric oxygen therapy in the treatment of sternal infection. The theoretical mechanisms would seem plausible, but at present there is only limited evidence to support its use. This review addresses the theory and evidence supporting the role of hyperbaric oxygen therapy in the treatment of sternal wound infection.

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“…The same relative behaviour of the approaches has been observed in two other applications concerning the effect of postoperative wound infections and ventilator-associated (Schulgen, 1995), although the absolute effect was quite different in the two studies (Kappstein et al, 1992a(Kappstein et al, , 1992b.…”

Section: Summary Of Resultsmentioning

confidence: 55%

“…A matching procedure is frequently applied to estimate the extra stay attributable to nosocomial infections (Leu et al, 1989;Kappstein et al, 1992aKappstein et al, , 1992bPittet et al, 1994). For each infected patient (case) one or several control patients are selected from the pool of patients who are discharged from hospital without having acquired an infection and who are as similar as possible to the case with respect to specified risk factors for duration of hospitalisation.…”

Section: The Matching Approachmentioning

confidence: 99%

Estimation of prolongation of hospital stay attributable to nosocomial infections: New approaches based on multistate models

Schulgen

Schumacher

1996

Lifetime Data Anal

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Evaluation of the impact of nosocomial infection on duration of hospital stay usually relies on estimates obtained in prospective cohort studies. However, the statistical methods used to estimate the extra length of stay are usually not adequate. A naive comparison of duration of stay in infected and non-infected patients is not adequate to estimate the extra hospitalisation time due to nosocomial infections. Matching for duration of stay prior to infection can compensate in part for the bias of ad hoc methods. New model-based approaches have been developed to estimate the excess length of stay. It will be demonstrated that statistical models based on multivariate counting processes provide an appropriate framework to analyse the occurrence and impact of nosocomial infections. We will propose and investigate new approaches to estimate the extra time spent in hospitals attributable to nosocomial infections based on functionals of the transition probabilities in multistate models. Additionally, within the class of structural nested failure time models an alternative approach to estimate the extra stay due to nosocomial infections is derived. The methods are illustrated using data from a cohort study on 756 patients admitted to intensive care units at the University Hospital in Freiburg.

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Added Hospital Stay Due to Wound Infections Following Cardiac Surgery

Cited by 46 publications

References 2 publications

Nosocomial Pneumonia: A Cost-of-Illness Analysis

Nosocomial Pneumonia: A Cost-of-Illness Analysis

The role of hyperbaric oxygen therapy in the treatment of sternal wound infection

Estimation of prolongation of hospital stay attributable to nosocomial infections: New approaches based on multistate models

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