Research Article: Clinical and Financial Outcomes Due to Methicillin Resistant Staphylococcus aureus Surgical Site Infection: A Multi-Center Matched Outcomes Study

Date Published: December 15, 2009

Publisher: Public Library of Science

Author(s): Deverick J. Anderson, Keith S. Kaye, Luke F. Chen, Kenneth E. Schmader, Yong Choi, Richard Sloane, Daniel J. Sexton, Michael Otto.

Abstract: The clinical and financial outcomes of SSIs directly attributable to MRSA and methicillin-resistance are largely uncharacterized. Previously published data have provided conflicting conclusions.

Partial Text: Surgical site infections (SSIs) are well known to lead to adverse clinical and financial outcomes for patients. The average SSI leads to approximately one week of additional hospitalization and increases the risk of death 2- to 11-fold compared to uninfected surgical patients [1], [2], [3]. In addition, SSIs lead to significant hospital costs. Each SSI costs approximately $12,000–$35,000 (2007 USD), depending on the type of procedure. In total, SSIs cost the US healthcare system approximately $10 billion annually [4].

A total of 278 patients with SSI due to S. aureus were identified following 141,345 procedures during the study period (overall rate of SSI due to S. aureus = 0.20/100 procedures); 150 patients were diagnosed with SSI due to MRSA (54% of SSI due to S. aureus; rate of SSI due to MRSA = 0.11/100 procedures) and 128 patients were diagnosed with SSI due to MSSA (rate of SSI due to MSSA = 0.09/100 procedures). Table 1 summarizes key demographic, clinical, and surgical variables.

Our study represents the largest study to date of outcomes due to SSI due to MRSA. Our findings confirm that SSIs due to MRSA lead to significant patient suffering and provide quantitative estimates of the staggering costs of these infections. SSI due to MRSA led to a 7-fold increased risk of death, a 35-fold increased risk of hospital readmission, more than 3 weeks of additional hospitalization, and more than $60,000 of additional charges compared to uninfected controls.



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