Surgical-site infection due to Staphylococcus aureus among elderly patients: mortality, duration of hospitalization, and cost.
OBJECTIVE
To examine the impact of surgical-site infection (SSI) due to Staphylococcus aureus on mortality, duration of hospitalization, and hospital charges among elderly surgical patients and the impact of older age on these outcomes by comparing older and younger patients with S. aureus SSI.


METHODS
A nested cohort study.


METHODS
A 750-bed, tertiary-care hospital and a 350-bed community hospital.


METHODS
Ninety-six elderly patients (70 years and older) with S. aureus SSI were compared with 2 reference groups: 59 uninfected elderly patients and 131 younger patients with S. aureus SSI.


RESULTS
Compared with uninfected elderly patients, elderly patients with S. aureus SSI were at risk for increased mortality (odds ratio [OR], 5.4; 95% confidence interval [CI95], 1.5-20.1), postoperative hospital-days (2.5-fold increase; CI95, 2.0-3.1), and hospital charges (2.0-fold increase; CI95, 1.7-2.4; dollar 41,117 mean attributable charges per SSI). Compared with younger patients with S. aureus SSI, elderly patients had increased mortality (adjusted OR, 2.9; CI95, 1.1-7.6), hospital-days (9 vs 13 days; P = .001), and median hospital charges (dollar 45,767 vs dollar 85,648; P < .001).


CONCLUSIONS
Among elderly surgical patients, S. aureus SSI was independently associated with increased mortality, hospital-days, and cost. In addition, being at least 70 years old was a predictor of death in patients with S. aureus SSI.
McGarry
Sarah A
SA
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Engemann
John J
JJ
Schmader
Kenneth
K
Sexton
Daniel J
DJ
Kaye
Keith S
KS
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003428:Cross Infection / Q000191:economics* / Q000382:microbiology / Q000401:mortality*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000191:economics* / Q000401:mortality*; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D013530:Surgical Wound Infection / Q000191:economics* / Q000382:microbiology / Q000401:mortality*; D013997:Time Factors