Mortality, length of hospitalization, and costs associated with invasive fungal infections in high-risk patients.
OBJECTIVE
The mortality, length of hospitalization, and costs associated with invasive fungal infections (IFIs) in hospitalized patients were studied.


METHODS
This retrospective database study used data from the 2004 Healthcare Cost and Utilization Project Nationwide In-patient Sample. Patients were selected for inclusion based on diagnostic codes corresponding to an IFI. A control group was matched to the IFI group based on high-risk conditions (i.e., cancer, infection with human immunodeficiency virus, chronic obstructive pulmonary disease, diabetes mellitus, and solid-organ, hematopoietic stem cell, or bone marrow transplant), age, sex, and hospital region and teaching status. Excess mortality, length of hospital stay, and costs were estimated as the differences between the IFI and control groups.


RESULTS
A total of 11,881 patients were identified with a discharge diagnosis of an IFI who could be matched to a control. Frequent infections included candidiasis (40.2%), other mycoses (36.3%), and aspergillosis (16.4%). Patients with IFIs had a significantly higher mortality rate (15% versus 5%), mean +/- S.E. length of stay (18.7 +/- 0.4 days versus 7.3 +/- 0.1 days), and mean +/- S.E. costs ($44,726 +/- $1,255 versus $15,445 +/- $404) (p < 0.001 for all comparisons) than did patients without IFIs. The burden of IFIs varied by high-risk condition (highest for transplant recipients and patients with cancer) and type of infection (highest for candidiasis, zygomycosis, and aspergillosis).


CONCLUSIONS
Examination of a large database showed that, compared with high-risk patients without IFIs, those with IFIs had higher mortality, a longer hospital stay, and higher costs associated with their hospitalization.
Menzin
Joseph
J
Boston Health Economics, Inc., Waltham, MA 02451, USA. jmenzin@bhei.com
Meyers
Juliana L
JL
Friedman
Mark
M
Perfect
John R
JR
Langston
Amelia A
AA
Danna
Robert P
RP
Papadopoulos
George
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006304:Health Status; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000191:economics* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult