[Cost differences in the treatment of severe sepsis between survivors and non-survivors on the first day of intensive care admission].
BACKGROUND
Patients admitted to intensive care unit with severe sepsis have high mortality and use significant resources.


OBJECTIVE
Determination of variable cost differences on day 1 between survivors and non-survivors of severe sepsis in Hungary.


METHODS
A sample of 6 intensive care units (ICU) included 70 patients who were admitted with severe sepsis to their ICU. Retrospective data collection of resource consumption for 24 hours following ICU admission using medical and nursing records. 59 different resource uses were collected separately for radiology, biochemistry and disposables. Blood products and drugs/fluids were collected individually. The authors identified the price of each resource for the cost calculation.


RESULTS
The ICU mortality of severe sepsis in our sample was found to be 64%, the average length of stay for survivors was 19.9 (SD +/- 11.4) and for non-survivors was 13.0 (SD +/- 8.5). Mean ICU variable cost on day 1 of severe sepsis was HUF 60 957 (247 Euro), more for non-survivors (HUF 70 835 vs. 40 108, p = 0.020). The use of blood products is higher in non-survivors ( p = 0.047) and so is the use of drugs/fluids ( p = 0.003). The use of more colloids ( p = 0.016) and more expensive antibiotics ( p = 0.021) was responsible for the higher drugs/fluids spending in non-survivors.


CONCLUSIONS
The mortality of severe sepsis is high and the cost of sepsis treatment is low in Hungary compared to international data. Non-survivors cost almost twice as much even on day 1, this warrants the need for early diagnosis and adequate treatment.
Csomós
Akos
A
Semmelweis Egyetem, Altalános Orvostudományi Kar I. Sebészeti Klinika, Aneszteziológiai és Intenzív Terápiás Osztály Budapest. csomos@seb1.sote.hu
Szentkereszty
Zoltán
Z
Fülesdi
Béla
B
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D016913:Blood Component Transfusion / Q000191:economics; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007362:Intensive Care Units / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009737:Nursing Records; D010343:Patient Admission / Q000191:economics*; D012189:Retrospective Studies; D018805:Sepsis / Q000191:economics* / Q000401:mortality* / Q000628:therapy; D017741:Survivors / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents