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National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions

The American journal of cardiology, 2019-10, Vol.124 (7), p.1140-1148 [Peer Reviewed Journal]

2019 Elsevier Inc. ;Copyright © 2019 Elsevier Inc. All rights reserved. ;2019. Elsevier Inc. ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2019.06.029 ;PMID: 31371062

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Title:
National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions
Author: Miller, P. Elliott ; Guha, Avirup ; Khera, Rohan ; Chouairi, Fouad ; Ahmad, Tariq ; Nasir, Khurram ; Addison, Daniel ; Desai, Nihar R.
Subjects: Adolescent ; Adult ; Bacteremia - epidemiology ; Bacteria ; Bypass ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - surgery ; Catheter-Related Infections - epidemiology ; Clostridium difficile ; Codes ; Cohort Studies ; Congestive heart failure ; Coronary artery ; Coronary vessels ; Cross Infection - epidemiology ; Databases, Factual ; Female ; Fibrillation ; Flutter ; Grafting ; Health care ; Health care policy ; Heart ; Heart failure ; Hospitalization ; Humans ; Incidence ; Infections ; Male ; Medical instruments ; Middle Aged ; Morbidity ; Mortality ; Myocardial infarction ; Nosocomial infections ; Pneumonia ; Surgery ; Survival Rate ; Trends ; Urinary tract ; Urinary Tract Infections - epidemiology ; Variables ; Ventilator-associated pneumonia ; Vibration ; Young Adult
Is Part Of: The American journal of cardiology, 2019-10, Vol.124 (7), p.1140-1148
Description: Healthcare-associated infections (HAI) are generally preventable causes of increased cost, morbidity, and mortality. Further, HAI carry penalties in the era of hospital value-based care. However, very little is known about the incidence and outcomes of HAI among patients hospitalized with common cardiovascular conditions. Using a national database, we identified adults aged ≥18 years hospitalized with 5 common cardiovascular conditions, including heart failure, acute myocardial infarction, coronary artery bypass grafting, cardiogenic shock, and atrial fibrillation or flutter. We assessed for temporal trends in incidence, cost, length of stay (LOS), and mortality associated with ventilator-associated pneumonia, catheter-associated urinary tract infections, central line-associated bloodstream infection, and Clostridium difficile infections. Between 2008 and 2015, we identified 159,021 hospitalizations ≥1 HAI (49.6% heart failure, 20.4% acute myocardial infarction, 10.5% coronary artery bypass grafting, 18.6% cardiogenic shock, and 11.9% atrial fibrillation or flutter). Clostridium difficile infections (75.4%) were the most common followed by catheter-associated urinary tract infections (15.1%), ventilator-associated pneumonia (7.9%), and central line-associated bloodstream infection (3.1%). Nearly half of the patients (46.3%) with HAI required discharge to a skilled care facility compared with 15.7% of patients who did not. After propensity matching, HAI remained associated with an increased LOS (4.9 vs 9.6 days, p <0.0001), total hospital charges ($79,227 vs $50,699, p <0.0001), and in-hospital mortality (13% vs 10.4%, p <0.0001) compared with patients who did not acquire a HAI. In conclusion, patients with cardiovascular disease acquiring a HAI had substantially higher costs, LOS, and mortality.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2019.06.029
PMID: 31371062
Source: AUTh Library subscriptions: ProQuest Central
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National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions

2019 Elsevier Inc. ;Copyright © 2019 Elsevier Inc. All rights reserved. ;2019. Elsevier Inc. ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2019.06.029 ;PMID: 31371062

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