Attributable length of stay and cost for pediatric and neonatal central line-associated bloodstream infections in Greece

Karagiannidou, Sofia; Zaoutis, Theoklis E.; Maniadakis, N; Papaevangelou, Vassiliki; Kourlaba, Georgia

doi:10.1016/j.jiph.2018.12.004

Cited by 19 publications

(26 citation statements)

References 27 publications

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“…This is perhaps due to the increased risks associated with parenteral nutrition and indwelling catheters, including central line‐associated blood stream infections. Previous studies have shown that hospitalization due to central line‐associated bloodstream infections results in longer length of stay and increased healthcare costs . Similarly, patients in our cohort with central line‐associated bloodstream infections also incurred higher healthcare burden.…”

Section: Discussionsupporting

confidence: 57%

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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Background Pediatric intestinal pseudo‐obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden. Methods We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD‐10 codes were used to identify patients 0‐18 years with pediatric intestinal pseudo‐obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank‐sum test were used. Results In 2016, there were 1671 inpatient discharges from US hospitals for patients 0‐18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94‐1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27‐1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530‐120 961) and a median (IQR) length of stay of 6 days (3‐14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden. Conclusions Pediatric intestinal pseudo‐obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.

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Section: Discussionsupporting

confidence: 57%

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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“…1). 29,30,[32][33][34][35][36][39][40][41][42][43][44] The main characteristics of the participating studies are listed in Table 1. Of the included studies, 4 were conducted in a hematologyoncology unit, 6,24,25,44 6 involved NICU patients, 29,34,38,39,41,42 6 involved PICU patients, 30,31,35,37,40,43 and 5 involved a mixed pediatric population.…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, 4 were conducted in a hematologyoncology unit, 6,24,25,44 6 involved NICU patients, 29,34,38,39,41,42 6 involved PICU patients, 30,31,35,37,40,43 and 5 involved a mixed pediatric population. 26,28,32,33,36 In most of the studies, 24,26,[28][29][30][31][32][34][35][36][37][39][40][41][42][43][44] HA-BSI was defined according to CDC/NHSN criteria. [45][46][47] In 1 study 38 the Vermont Oxford Network (VON) criteria 48,49 were used; in another, ICD-9-CM codes were used 25 ; and in 2 other studies, institution-based criteria were considered.…”

Section: Resultsmentioning

confidence: 99%

“…6,33 These institution-based criteria were reasonably chosen by the authors, and they were very much similar to the CDC/NHSN criteria. In addition, 10 of the participating studies were characterized as prospective cohort studies, 24,26,28,30,31,35,37,40,41,44 5 were characterized as retrospective cohort studies, 25,33,36,38,39 and 6 were characterized as case-control studies. 6,29,32,34,42,43 However, we decided that the included case-control studies should ultimately be classified as either retrospective cohorts 6,32,34,42 or as prospective cohorts 29,43 because they actually measured outcomes after prospective or retrospective surveillance of matched BSI and non-BSI children until discharge or death.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, with regard to the methodology of the studies that presented attributable HA-BSI LOS and/or cost, 8 studies used a time-fixed statistical approach 25,30,32,37,38,41,43,44 : 7 of these studies presented time-matched outcomes of BSI and non-BSI patients 6,24,26,28,29,36,39 and only 1 study used multistate modeling to estimate attributable HA-BSI LOS. 33…”

Section: Resultsmentioning

confidence: 99%

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Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

Karagiannidou

Triantafyllou

Zaoutis

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective:To estimate the attributable mortality, length of stay (LOS), and healthcare cost of pediatric and neonatal healthcare-acquired bloodstream infections (HA-BSIs).Design:A systematic review and meta-analysis.Methods:A systematic search (January 2000–September 2018) was conducted in PubMed, Cochrane, and CINAHL databases. Reference lists of selected articles were screened to identify additional studies. Case–control or cohort studies were eligible for inclusion when full text was available in English and data for at least 1 of the following criteria were provided: attributable or excess LOS, healthcare cost, or mortality rate due to HA-BSI. Study quality was evaluated using the Critical Appraisal Skills Programme Tool (CASP). Study selection and quality assessment were conducted by 2 independent researchers, and a third researcher was consulted to resolve any disagreements. Fixed- or random-effect models, as appropriate, were used to synthesize data. Heterogeneity and publication bias were evaluated.Results:In total, 21 studies were included in the systematic review and 13 studies were included in the meta-analysis. Attributable mean LOS ranged between 4 and 27.8 days; healthcare cost ranged between $1,642.16 and $160,804 (2019 USD) per patient with HA-BSI; and mortality rate ranged between 1.43% and 24%. The pooled mean attributable hospital LOS was 16.91 days (95% confidence interval [CI], 13.70–20.11) and the pooled attributable mortality rate was 8% (95% CI, 6–9). A meta-analysis was not conducted for cost due to lack of eligible studies.Conclusions:Pediatric HA-BSIs have a significant impact on mortality, LOS, and healthcare cost, further highlighting the need for implementation of HA-BSI prevention strategies.

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Next Steps for Health Care-Associated Infections in the Neonatal Intensive Care Unit

Brachio

Saiman

2023

Clinics in Perinatology

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Attributable length of stay and cost for pediatric and neonatal central line-associated bloodstream infections in Greece

Cited by 19 publications

References 27 publications

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

Next Steps for Health Care-Associated Infections in the Neonatal Intensive Care Unit

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