title: Excess cost associated with Staphylococcus aureus poststernotomy mediastinitis.
abstract: OBJECTIVE
  To determine the additional cost attributable to Staphylococcus aureus poststernotomy mediastinitis (PSM) following sternotomy for cardiac surgery at Green Lane Hospital.
  
  
  METHODS
  A retrospective case-control study was undertaken. Nine patients with S. aureus PSM (cases) were matched with nine patients without PSM (controls) for gender, age, type of surgical procedure, time of procedure, and presence of diabetes mellitus. Patients' length and cost of hospital stay (for the admission associated with the initial surgery and any subsequent admissions associated with complications of that surgery) were obtained from the hospital's clinical costing system.
  
  
  RESULTS
  S. aureus PSM was associated with longer average length of hospital stay, 42.6+/-18.7 vs 10.4+/-4.0 days (p=0.005). The mean cost per patient in New Zealand dollars was 30,527 dollars +/-10,489 dollars for controls and 76,104 dollars +/- 31,460 dollars for cases, and the mean excess cost associated with S. aureus PSM was 45,677 dollars per patient.
  
  
  CONCLUSIONS
  This study illustrates the significant cost of deep surgical site infection, both in terms of length of hospital stay and hospital revenue, and highlights the potential cost benefit of successful strategies to reduce surgical site infection such as S. aureus PSM.
authors.affiliation: Department of Clinical Microbiology, Auckland District Health Board, Auckland, New Zealand. aupton@fhcrc.org
authors.forename: Arlo
authors.initials: A
authors.lastname: Upton
authors.forename: Pat
authors.initials: P
authors.lastname: Smith
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000191:economics; D016022:Case-Control Studies; D003365:Costs and Cost Analysis; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008480:Mediastinitis / Q000191:economics*; D008875:Middle Aged; D009520:New Zealand; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000191:economics*; D013211:Staphylococcus aureus; D013530:Surgical Wound Infection / Q000191:economics*; D013908:Thoracotomy / Q000191:economics