Surgical-site infection due to Staphylococcus aureus among elderly patients: mortality, duration of hospitalization, and cost

Infect Control Hosp Epidemiol. 2004 Jun;25(6):461-7. doi: 10.1086/502422.

Abstract

Objectives: To examine the impact of surgical-site infection (SSI) due to Staphylococcus aureus on mortality, duration of hospitalization, and hospital charges among elderly surgical patients and the impact of older age on these outcomes by comparing older and younger patients with S. aureus SSI.

Design: A nested cohort study.

Setting: A 750-bed, tertiary-care hospital and a 350-bed community hospital.

Patients: Ninety-six elderly patients (70 years and older) with S. aureus SSI were compared with 2 reference groups: 59 uninfected elderly patients and 131 younger patients with S. aureus SSI.

Results: Compared with uninfected elderly patients, elderly patients with S. aureus SSI were at risk for increased mortality (odds ratio [OR], 5.4; 95% confidence interval [CI95], 1.5-20.1), postoperative hospital-days (2.5-fold increase; CI95, 2.0-3.1), and hospital charges (2.0-fold increase; CI95, 1.7-2.4; dollar 41,117 mean attributable charges per SSI). Compared with younger patients with S. aureus SSI, elderly patients had increased mortality (adjusted OR, 2.9; CI95, 1.1-7.6), hospital-days (9 vs 13 days; P = .001), and median hospital charges (dollar 45,767 vs dollar 85,648; P < .001).

Conclusions: Among elderly surgical patients, S. aureus SSI was independently associated with increased mortality, hospital-days, and cost. In addition, being at least 70 years old was a predictor of death in patients with S. aureus SSI.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Academic Medical Centers / statistics & numerical data*
  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Cross Infection / economics*
  • Cross Infection / microbiology
  • Cross Infection / mortality*
  • Female
  • Hospital Costs* / statistics & numerical data
  • Hospitals, Community / statistics & numerical data*
  • Humans
  • Length of Stay* / economics
  • Length of Stay* / statistics & numerical data
  • Male
  • Methicillin Resistance
  • Middle Aged
  • North Carolina / epidemiology
  • Regression Analysis
  • Risk Factors
  • Staphylococcal Infections / economics*
  • Staphylococcal Infections / mortality*
  • Staphylococcus aureus* / isolation & purification
  • Staphylococcus aureus* / pathogenicity
  • Surgical Wound Infection / economics*
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / mortality*
  • Time Factors