Attributable cost and length of stay for patients with central venous catheter-associated bloodstream infection in Mexico City intensive care units: a prospective, matched analysis.
BACKGROUND
No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico.


OBJECTIVE
To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City.


METHODS
An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI.


METHODS
Adult ICUs in 3 hospitals in Mexico City.


METHODS
A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments.


RESULTS
For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was US dollars 598, the mean extra hospital cost was US dollars 11,591, and the attributable extra mortality was 20%.


CONCLUSIONS
In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.
Higuera
Francisco
F
General Hospital, Mexico City, Mexico.
Rangel-Frausto
Manuel Sigfrido
MS
Rosenthal
Victor Daniel
VD
Soto
Jose Martinez
JM
Castañon
Jorge
J
Franco
Guillermo
G
Tabal-Galan
Natividad
N
Ruiz
Javier
J
Duarte
Pablo
P
Graves
Nicholas
N
D000328:Adult; D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D018805:Sepsis / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D012720:Severity of Illness Index