摘要
目的研究神经外科手术后中枢神经系统感染(NCNSI)对患者手术后住院费用和住院时长的影响,为感染防控提供卫生经济学支持。方法回顾性收集2015年1月1日—2020年12月31日在上海某三级甲等综合医院神经外科接受手术患者的临床资料。根据患者手术后是否发生NCNSI分为感染组和非感染组,采用1∶1倾向性评分匹配法构建协变量均衡的数据库,比较匹配后两组患者手术后住院费用和住院时长。结果共纳入1661例神经外科手术后患者,83例发生NCNSI,发病率为5.00%。倾向性评分匹配成功77对。匹配后,感染组和非感染组患者总住院费用中位数分别为96487、44691元,直接经济损失为51796元;中位住院时间分别是27、10 d,感染组额外延长17 d。感染组手术后的多项住院费用高于非感染组,以实验室检测费、二次手术费、抗菌药物费和一次性耗材费增加最为明显。结论神经外科手术患者发生NCNSI可导致手术后住院时间延长、住院费用增加,倾向性评分匹配法可为相关经济负担研究提供更准确的结果。
Objective To study the impact of neurosurgical central nervous system infection(NCNSI) after neurosurgical operation on post-operative hospitalization expense and length of hospital stay, and provide health economic support for infection prevention and control. Methods Clinical data of patients who underwent neurosurgical operation in a tertiary first-class comprehensive hospital in Shanghai from January 1, 2015 to December 31, 2020 were retrospectively collected. According to whether NCNSI occurred after operation, patients were divided into infection group and non-infection group, database of covariate equilibrium was constructed with 1∶1 propensity score matching method, post-operative expenses and length of hospital stay of two groups of matched patients were compared. Results A total of 1 661 patients after neurosurgical operation were included, 83 of whom developed NCNSI, with an incidence of 5.00%, 77 pairs of propensity scores were matched successfully. After matching, the median of total hospitalization expenses in patients in infection group and non-infection group were 96 487 Yuan and 44 691 Yuan respectively, direct economic loss was 51 796 Yuan;the median length of hospital stay was 27 days and 10 days respectively, and infection group was extended for additional 17 days. Conclusion NCNSI in neurosurgery patients prolongs length of hospital stay and increases hospitalization expenses, propensity score matching method can provide more accurate results for the economic burden research.
作者
张蕾
富小凤
贾佳
ZHANG Lei;FU Xiao-feng;JIA Jia(Department of Neurosurgery Intensive Care Unit,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2022年第10期1000-1005,共6页
Chinese Journal of Infection Control
