title: The cost of infection in hip arthroplasty: a matched case-control study.
abstract: OBJECTIVE
  Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain.
  
  
  METHODS
  Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis.
  
  
  RESULTS
  This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms.
  
  
  CONCLUSIONS
  SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.
authors.affiliation: Colsanitas, Bogotá, Colombia. Electronic address: aegonzalezv@gmail.com.
authors.forename: A E
authors.initials: AE
authors.lastname: González-Vélez
authors.affiliation: Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Romero-Martín
authors.affiliation: Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Villanueva-Orbaiz
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Díaz-Agero-Pérez
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Robustillo-Rodela
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Monge-Jodra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D016022:Case-Control Studies; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D013530:Surgical Wound Infection / Q000191:economics*
keywords: Artroplastia de cadera; Costes hospitalarios; Estancia hospitalaria; Hip arthroplasty; Hospital costs; Infección de localización quirúrgica; Length of stay; Methicillin-resistant Staphylococcus aureus; Staphylococcus aureus resistente a la meticilina; Surgical wound infection