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Health economic evaluation related to nosocomial infection of patients with surgery of hypertensive intracerebral hemorrhage |
TIAN Xiaoling1, WANG Hongyan2, SUN Jihua3, ZHANG Xiaoqin2, SUN Liandong1, XU Hongmei4 |
1 Pediatric Surgical Department ,Binzhou Medical University Hospital,Binzhou 256603,P.R.China; 2 Neurosurgery Department,Binzhou Medical University Hospital; 3 Infection Management Office, Binzhou MedicalUniversity Hospital; 4 Nursing Department,Binzhou Medical University Hospital |
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Abstract Objective To investigate the prevalence of nosocomial infection in hypertensive intracerebral hemorrhage patients by analyzing retrospective investigation of nosocomial infection in 272 patients with neurosurgical hypertensive intracerebral hemorrhage in a III-A general hospital,and to analyze the related factors of nosocomial infection and find out the infection key factors and links, in order to improve the clinical diagnosis, treatment and nursing work.Methods Totally 272 patients with hypertensive intracerebral hemorrhage were selectedina III-A hospital from January 1, 2015 to December 31, 2016. A retrospective survey of hospital infection in all patients with hypertensive intracerebral hemorrhage.The survey included gender, age, awareness status, presence or absence of other diseases, length of hospital stay,catheter retention time,and invasive operation and so on.The data were measured by the standard deviation, the rate and the percentage.The χ2 test was used to compare the count data. The T test and the rank sum test were used to measure the data. Multivariate analysis was logistic regression and P<0.05 was taken as statistically significant.Results A total of 272 patients underwent hypertensive intracerebral hemorrhage surgery,57 patients with nosocomial infection,and the incidence of infection was 20.96%. Infection occurred in 69 cases, with the incidence 25.37%.Between 2015 and 2016,the incidence of nosocomial infection was declining.Lower respiratorytract ranked first in the parts of patients with hypertensive intracerebral hemorrhage, accounting for 59.42%.Bacterial culture was carried out for 36 infected patients and 43 strains were detected including 32 strains of Gram-negative bacteria,mainly Acinetobacter baumannii; 6 strains of Gram-positive strains,of which the most common was Staphylococcus aureus.Whether the ICU stay and the number of ICU stay days in the hospital were the independent risk factorsof hospital infection.Conclusion The incidence of nosocomial infection of patients with hypertensive intracerebral hemorrhage is higher than that of the general nosocomial infection in the same period.Theadmission to ICU, and the hospitalization days in ICU, is an independent risk factor for nosocomial infection in patients with hypertensive intracerebral hemorrhage.Control measures should be taken to prevent these risk factors, to shorten the time of stay in ICU, and to reduce the hospital infection rate. Hospital infection resulted in an increase in hospitalization costs and prolonged hospitalization. Increased hospitalization costs and prolonged hospitalization days were different at the sites of infection and the patients’age.
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Received: 16 August 2018
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