Risk Factor And Economic Burden Evaluation Of Healthcare-Associated Infection Among Pituitary Adenoma Patients Undergoing Surgical Treatment

ObjectivesTo explore the risk factors of healthcare-associated infection(HAI)among pituitary adenoma patients undergoing surgical treatment systematically by investigating the status of HAI in target population.In addition,the economic burden of HAI was evaluated.Hopefully,scientific basis could be provided for surgeon to take preventive and control measures to reduce the incidence of HAI,at the same time,evidence could be provided for health administrative departments to formulate HAI preventive and control strategies and promote the rational use of medical resources.MethodsA total of 565 patients who met the inclusion criteria from January 1,2018 to December 31,2019 in a tertiary first-class general hospital were taken as the research objects.Self-designed forms," Survey forms of Healthcare-associated Infection in Patients with Pituitary Adenoma " and "Investigation Form of Economic Burden in Hospital Patients with Pituitary Adenoma ",were used to collect patient data.The research content includes the status of HAI.the risk factors of HAI,and the economic burden caused by HAI.SPSS 24.0 was used for statistical analysis.(])Risk factors:mean,standard deviation,median,rate and composition ratio were used for statistical description;T test,Chi-square test,Mann-Whitney U test and Fisher exact probability were used to describe difference between groups.Logistic regression was used to analyze risk factors.(2)Economic burden evaluation:propensity score weighting(PSW)was used to estimate the economic burden;the propensity score matching(PSM)method was used to match the infected group with the non-infected group by 1:1,and the Wilcoxon rank sum test was used to analyze the economic burden of various HAI.Results1.A total of 565 patients were included in this study:266 males(47.08%)and 299 females(52.92%)patients.The average age was 50.17±12.57 years old.2.56 HAI cases(62 episodes)were identified with the incidence rate reaching 9.91%,and the incidence of HAI cases was 10.97%.Infected sites:23 cases of surgical site infection(composition ratio 41.07%),14 cases of pulmonary infection(composition ratio 25.00%),5 cases of urinary tract infection(composition ratio 8.93%),9 cases of upper respiratory tract infection(composition ratio 16.07%),and 5 cases of multiple infections(composition ratio 8.93%).3.21 strains of pathogenic bacteria were detected in the specimens submitted:9 strains of Gram-positive bacteria(42.86%),10 strains of Gram-negative bacteria(47.62%)and 2 strains of fungi(9.52%).4.Logistic regression analysis was used to screen 6 independent risk factors for HAI among pituitary adenoma patients undergoing surgical treatment:cerebrospinal fluid rhinorrhea,tumor diameter,length of hospital stay,duration of antibiotic use,number of lumbar punctures,and body temperature on the first day after surgery.5.Hospitalization cost of hospital-infected patients was 61,658.84 yuan,while for non-infected patients was 40,956.77 yuan.Direct economic burden of HAI was 20,702.07 yuan,of which the western medicine cost burden was the highest(9087.43 yuan).Indirect economic burden of HAI was 3024.30 yuan.Besides,the infection extended hospital stay for 7.5 days.ConclusionsThe incidence of HAI in pituitary adenoma patients undergoing surgical treatment is quite high.Cerebrospinal fluid rhinorrhea,tumor diameter,length of hospital stay,duration of antibiotic use,number of lumbar spine punctures,and body temperature on the first day after surgery are independent risk factors for HAI in this population.To reduce the incidence of HAI in this population,measures should be taken.The economic burden of HAI in pituitary adenoma patients undergoing surgical treatment is high,and the economic burden of different infection sites is also different.