Evidence map›Paper›PMID 37085906›Full record

ArticleAntimicrobial resistance and infection control2023

Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting.

Aleksa Despotović, Nataša Milić, Anđa Cirković, Branko Milošević, Snežana Jovanović, Vesna Mioljević, Vesna Obradović, Gordana Kovačević, Goran Stevanović

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Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Aleksa DespotovićDepartment of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. alexadespotovic21@gmail.com.
Nataša MilićDepartment of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Anđa CirkovićDepartment of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Branko MiloševićFaculty of Medicine, University of Belgrade, Belgrade, Serbia.
Snežana JovanovićDepartment of Microbiology, University Clinical Centre of Serbia, Belgrade, Serbia.
Vesna MioljevićDepartment of Hospital Epidemiology and Nutrition Hygiene, University Clinical Centre of Serbia, Belgrade, Serbia.
Vesna ObradovićTeaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia.
Gordana KovačevićTeaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia.
Goran StevanovićFaculty of Medicine, University of Belgrade, Belgrade, Serbia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHospital-acquired infections (HAIs) are a global public health problem and put patients at risk of complications, including death. HAIs increase treatment costs, but their financial impact on Serbia's healthcare system is unknown. Our goal was to assess incremental costs of HAIs in a tertiary care adult intensive care unit (ICU) that managed COVID-19 patients.

methodsA retrospective study from March 6th to December 31st, 2020 included patients with microbiologically confirmed COVID-19 (positive rapid antigen test or real-time polymerase chain reaction) treated in the ICU of the Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia. Demographic and HAI-specific data acquired in our ICU were collected, including total and stratified medical costs (services, materials, laboratory testing, medicines, occupancy costs). Median total and stratified costs were compared in relation to HAI acquisition. Linear regression modelling was used to assess incremental costs of HAIs, adjusted for age, biological sex, prior hospitalisation, Charlson Comorbidity Index (CCI), and Glasgow Coma Scale (GCS) on admission. Outcome variables were length of stay (LOS) in days and mortality.

resultsDuring the study period, 299 patients were treated for COVID-19, of which 214 were included. HAIs were diagnosed in 56 (26.2%) patients. Acinetobacter spp. was the main pathogen in respiratory (38, 45.8%) and bloodstream infections (35, 42.2%), the two main HAI types. Median total costs were significantly greater in patients with HAIs (€1650.4 vs. €4203.2, p < 0.001). Longer LOS (10.0 vs. 18.5 days, p < 0.001) and higher ICU mortality (51.3% vs. 89.3%, p < 0.001) were seen if HAIs were acquired. Patients with ≥ 2 HAIs had the highest median total costs compared to those without HAIs or with a single HAI (€1650.4 vs. €3343.4 vs. €7336.9, p < 0.001). Incremental costs in patients with 1 and ≥ 2 HAIs were €1837.8 (95% CI 1257.8-2417.7, p < 0.001) and €5142.5 (95% CI 4262.3-6022.7, p < 0.001), respectively.

conclusionsThis is the first economic evaluation of HAIs in Serbia, showing significant additional costs to our healthcare system. HAIs prolong LOS and influence ICU mortality rates. Larger economic assessments are needed to enhance infection control practices.

Indexed as

COVID-19Cross InfectionAdultHumansIntensive Care UnitsRetrospective StudiesTertiary Care CentersCOVID-19Economic evaluationHospital-acquired infectionsIntensive care unitMedical costsSerbia

Identifiers

PMID37085906
PMCPMC10120483

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.