Risk Factors And Direct Economic Burden Of Healthcare-Associated Infection Among Patients With Bone Neoplasms

ObjectivesTo investigate the status of healthcare-associated infection(HAI)among patients with bone neoplasms,analyze risk factors of HAI,and evaluate the direct economic burden caused by HAI,so as to provide scientific evidence for orthopedic medical staff to take measures of infection control and provide the theoretical basis for hospital infection prevention and control departments and health administration agencies to formulate infection control policies and rational allocation of medical resources.MethodsPatients hospitalized in the department of orthopedic in a tertiary comprehensive hospital during January 1st,2016 and December 31st,2018 were recruited using cluster sampling methods.The data were collected using the questionnaires of Healthcare-associated infection and risk factors among patients with bone neoplasms and Direct economic burden of healthcare-associated infection among patients with bone neoplasms.The patients were divided into the infected group and the uninfected group according to whether they suffered HAI,then the risk factors and direct economic burden of HAI were analyzed.SPSS 23.0 was used for data analysis.The risk factors of HAI were analyzed by Logistic regression analysis.In the analysis of direct economic burden,1:1 case-control matching was first used to balance confounding factors,and then the Wilcoxon rank sum test was used to analyze the direct economic burden caused by HAI.Results1.Overall,542 patients were enrolled in this study with 290 males and 252 females.The mean age was 32.68±18.72 years old.2.Among the 542 patients,43 HAI cases(44 episodes)were identified with the incidence rate reaching 7.93%,and the incidence of HAI cases was 8.12%.In the distribution of infection sites,surgical site infection was the main type of infection,with a composition ratio of 60.46%.The proportion of superficial surgical site infection was 25.58%,and that of deep surgical site infection was 34.88%.The second most common type of infection was respiratory tract infection(25.58%).The proportion of upper respiratory tract infection was 9.30%and that of lower respiratory tract infection was 16.28%.3.The main pathogens were gram-positive bacteria.Gram-positive bacteria accounted for 65.79%of all pathogenic bacteria,and gram-negative bacteria accounted for 34.21%of all pathogenic bacteria.4.The risk factors for HAI in patients with bone neoplasms were ASA score>3,glucocorticoid use,incision drainage tube indwelling for more than 7 days,and tumor site(pelvis).5.The total hospitalization cost of the infected group was RMB 77788.54 per person,the total hospitalization cost of the uninfected group was RMB 43561.75 per person,and the direct economic burden caused by HAI in patients with bone neoplasms was RMB 34226.79 per person.The length of stay of the infected group was 22.50 days per person,the length of stay of the uninfected group was 12.50 days per person,and HAI prolonged the length of stay by 10.00 days per person.ConclusionsThe surveillance of healthcare-associated infection among patients with bone neoplasms should be enhanced.ASA score?3,glucocorticoid use,incision drainage tube indwelling for more than 7 days,and tumor site(pelvis)are risk factors for HAI.Specific preventive and control measures should be taken to reduce infection rates according to the above risk factors.In addition,HAI causes huge economic burden and prolongs the length of stay.Multidisciplinary teams including physicians,nurses,and hospital infection managers should strengthen cooperation to monitor,analyze,and feedback on HAI and related risk factors in patients with bone neoplasms,so as to detection and control of HAI timely,reduce the infection rate and economic burden of HAI.and save medical costs and medical resources.