title: The burden of Staphylococcus aureus infections on hospitals in the United States: an analysis of the 2000 and 2001 Nationwide Inpatient Sample Database.
abstract: BACKGROUND
  Previous studies have investigated the impact of Staphylococcus aureus infections on individual hospitals, but to date, no study using nationally representative data has estimated this burden.
  
  
  METHODS
  This is a retrospective analysis of the 2000 and 2001 editions of the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample database, which represents a stratified 20% sample of hospitals in the United States. All inpatient discharge data from 994 hospitals in 28 states during 2000 and from 986 hospitals in 33 states during 2001, representing approximately 14 million inpatient stays, were analyzed to determine the association of S aureus infections with length of stay, total charges, and in-hospital mortality.
  
  
  RESULTS
  Staphylococcus aureus infection was reported as a discharge diagnosis for 0.8% of all hospital inpatients, or 292 045 stays per year. Inpatients with S aureus infection had, on average, 3 times the length of hospital stay (14.3 vs 4.5 days; P<.001), 3 times the total charges (48,824 US dollars vs 14,141 US dollars; P<.001), and 5 times the risk of in-hospital death (11.2% vs 2.3%; P<.001) than inpatients without this infection. Even when controlling for hospital fixed effects and for patient differences in diagnosis-related groups, age, sex, race, and comorbidities, the differences in mean length of stay, total charges, and mortality were significantly higher for hospitalizations associated with S aureus.
  
  
  CONCLUSIONS
  Staphylococcus aureus infections represent a considerable burden to US hospitals, particularly among high-risk patient populations. The potential benefits to hospitals in terms of reduced use of resources and costs as well as improved outcomes from preventing S aureus infections are significant.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, and Northwestern Memorial Hospital, Chicago, IL 60611, USA. gnoskin@northwestern.edu
authors.forename: Gary A
authors.initials: GA
authors.lastname: Noskin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Rubin
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Schentag
authors.forename: Jan
authors.initials: J
authors.lastname: Kluytmans
authors.forename: Edwin C
authors.initials: EC
authors.lastname: Hedblom
authors.forename: Maartje
authors.initials: M
authors.lastname: Smulders
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lapetina
authors.forename: Eric
authors.initials: E
authors.lastname: Gemmen
mesh_terms: D000367:Age Factors; D017281:Cost of Illness; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology