| Objective This Study was designed to analyses epidemiological characteristics and accurately measure the additional direct economic losses, average length of hospital day and mortality of elderly patients with nosocomial infection in a large general hospital, so as to provide the basis for improving elderly patients’nosocomial infection management.Methods Prospective analysis was performed on information of NI patients over 80yrs in a large general hospital during January 2012 to 2014. descriptive analysis on the epidemiological characteristics of nosocomial infection. Infection and no infection group matched 1:1 to get covariate equilibrium between group samples by using SPSS PSM, and SPSS 19.0 software was applied for statistical analysis.Results During the study period,8846 cases of hospitalized patients were included in our study, with 165258 hospitalization days,944 NI patients,1454 cases of infection. The NI incidence person rate was 10.67%, the NI incidence case rates was 16.44% and the prevalence of one thousand days was 8.80%o. The incidence rate of NI increased with the patients’age. The predominant infection type is respiratory infection, accounting for 49.66% of total NI infection,91.83% of which was low respiratory infection. The urinary tract infection and the bloodstream infection were common in our hospital, which accounted for 24.62% and 14.79% respectively. Surgical ICU ward, respiratory medicine, neurology, rehabilitation medicine, radiation therapy, neurosurgery, department of nephrology, oncology had higher NI person incidence rate than other departments, with incidence rate of 59.09%,29.78%, 29.03%,21.11%,18.92%,17.54%,16.83%,16.39%,10.75% respectively. The highest incidence of NI is in October (12.64%) and the lowest was in May (7.35%).The distribution of NI among four quarters presented as an irregular "U", with the lowest quarter in the second quarter. NI incidence rate was 0.57% among patients admitted for 2 to 7 days. Patients admitted for 8 to 14 days had NI rate of 2.69%, patients admitted for 15 to 30 days had NI rate of 13.55%,31 to 60 days had NI rate of 38.99%, in the hospital,61-90 days of NI rate was 70.43%, length of hospital stay more than 3 months of patient infection rate was 89.35%.Urinary related infection incidence was 5.88‰; the ventilator associated infection incidence was 5.14‰; the incidence of central venous catheter related infections 1.01‰.Nephrological ICU had higher infection rate, with CAUTI infection incidence of 19.87 (‰), the incidence of VAP was 15.27 (%o).2269 pathogenic bacteria were detected. Of which,1351 strains were gram-negative bacteria, accounting for 59.54%; fungus 585 strains (25.78%), Gram-positive bacteria were 333 strains (14.68%). Acinetobacter baumannii, staphylococcus aureus and coagulase negative staphylococcus resistance should pay special attention.836 pairs were successfully matched in total. Median average hospital day in infection and control groups were 31.0 days and 15.0 days, respectively, with median difference for 16.0 days (P<0.01). Median hospitalization cost in infection group was RMB101912.92, while in the control group RMB 43110.18, with median difference of RMB 58802.74 (P<0.01).The average daily infection cost was RMB 3675.17. The top 4 additional cost items were RMB 30084.7 for medicine, RMB 10391.55 for treatment, RMB 7347.25 for tests, and RMB 6477.76 for materials, which accounted for 92.3% of the total cost. Besides, the mortality rate increased by 29.5% in elderly patients with nosocomial infection. Conclusions Elderly hospitalized patients had higher high NI incidence. The nosocomial infection control work should consider NI as a main content of nosocomial infection management of medical institutions. We should pay more attention on key indicators and take more efforts on reducing NI incidence. |
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