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Healthcare utilization and costs associated with S. aureus and P. aeruginosa pneumonia in the intensive care unit: a retrospective observational cohort study in a US claims database

机译:重症监护病房中与金黄色葡萄球菌和铜绿假单胞菌肺炎相关的医疗保健利用率和成本:美国索赔数据库中的一项回顾性观察队列研究

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Staphylococcus aureus and Pseudomonas aeruginosa are major causes of pneumonia in intensive care unit (ICU) patients. Limited data exist regarding the health economic impact of S. aureus and P. aeruginosa pneumonias in the ICU setting. We conducted a retrospective observational cohort study using a 29.6 million enrollee US medical and pharmacy administrative claims database. ICU patients with S. aureus or P. aeruginosa infection per International Classification of Diseases, 9th ed. coding between 01/01/2007-8/31/2012 were compared with ICU patients without any pneumonia or infections of interest. Primary outcomes were costs in 2012 US dollars, healthcare utilization and all-cause mortality associated with hospital-acquired S. aureus or P. aeruginosa pneumonia, and the relative odds of incurring higher costs due to a comorbid condition. Patients with S. aureus or P. aeruginosa pneumonia had longer mean hospital (37.9 or 55.4 vs 7.2?days, P?
机译:金黄色葡萄球菌和铜绿假单胞菌是重症监护病房(ICU)患者肺炎的主要原因。关于ICU环境中金黄色葡萄球菌和铜绿假单胞菌肺炎对健康经济影响的数据有限。我们进行了一项回顾性观察队列研究,使用了2960万名美国医学和药学行政索赔数据库。根据《国际疾病分类》第9版,患有金黄色葡萄球菌或铜绿假单胞菌感染的ICU患者。将在01/01 / 2007-8 / 31/2012之间的编码与没有任何肺炎或目标感染的ICU患者进行了比较。主要结局包括:2012年的成本费用,与医院获得的金黄色葡萄球菌或铜绿假单胞菌肺炎相关的医疗保健利用率和全因死亡率,以及因合并症导致较高成本的相对几率。金黄色葡萄球菌或铜绿假单胞菌肺炎患者的平均住院时间较长(37.9或55.4 vs 7.2?天,P 。001),而ICU停留时间(6.9或14.8 vs 1.1?day,P 。001),机械通气率较高(62.6%或62.3%对7.4%,P 。001),死亡率更高(16.0%或20.2%对3.1%,P 。001),与平均总住院费用相比(分别为146,978美元或213,104美元vs 33,851美元,P 。001)。肺炎幸存者在30天之内再次住院的风险显着增加(27.2%或31.1%对15.3%,P <0.001)。合并症与肺炎人群的费用增加无关。在ICU金黄色葡萄球菌或铜绿假单胞菌肺炎患者中,医疗保健成本和资源利用率很高。减少这些感染的发生率可以在美国节省大量成本。

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