[Staphylococcus aureus infection in an acute geriatric unit].
OBJECTIVE
The aim of this study was to determine the risk of mortality, functional decline and institutionalization, as well as the hospital cost associated with patients with methicillin-resistant Staphylococcus aureus (MRSA) infection in an Acute Geriatric Unit (AGU).


METHODS
We retrospectively gathered data on patients admitted to the AGU over a 5-year period (from 1/1/2001 to 1/1/06). Mortality, institutionalization, functional impairment at discharge, length of hospital stay, and hospital costs were compared between patients with and without MRSA. MRSA infection was documented by the microbiology department using culture and antibiogram, as well as by clinical diagnosis of hospital infection registered in the medical record.


RESULTS
Data were obtained from 47 patients with MRSA (mean age 86.15+/-5.5 years) and from 4281 patients without MRSA (mean age 85.25+/-6 years). MRSA-infected patients had higher mortality (25.5% vs. 7.7%, p<0.001), worse functional status at discharge (Barthel index 39.43+/-33.05 vs. 55.24+/-34.99, p<0.01) and more frequent institutionalization (29% vs. 9%, p<0.001). Longer length of hospital stay (22.15+/-13.67 vs. 10.64+/-7.69 days, p<0.001) and higher hospital cost per patient (7517.71+/-4639.59 vs 3611.21+/-2609.98 euro, p<0.001) were also observed. In the multivariate analysis adjusted by age, sex, and baseline functional and cognitive status, MRSA infection was independently associated with higher mortality (OR=3.92; 95% CI=1.95-7.86), worse functional status at discharge (OR=2.48; 95% CI=1.22-5.01), institutionalization at discharge (OR=6.50; 95% CI=2.60-12.22), and substantial increase in length of hospital stay (Beta coefficient=11.55 days; 95% CI=9.32-13.75).


CONCLUSIONS
MRSA infection in the AGU is associated with higher mortality, worse functional status at discharge and a higher incidence of institutionalization, as well as significantly longer length of stay and higher hospital costs.
Gómez-Pavón
Javier
J
Servicio de Geriatría, Hospital Central de la Cruz Roja de Madrid, Madrid, España.
Rodríguez Salazar
Jaime
J
Fernández de la Puente
Eva
E
Baztán Cortés
Juan José
JJ
Ruipérez Cantera
Isidoro
I
González
Isabel
I
Cortés Bohórquez
Rosario
R
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005853:Geriatrics; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000191:economics / Q000401:mortality