神经外科肿瘤患者术后感染对住院日和住院费用的影响  

Influence of postoperative infection on hospitalization day and medical costs of patients with nervous system tumor

作　　者：林吉[1] 李莉[2] 李诗雨[1] 庄红娣[1] 尹维佳[1] Lin Ji;Li Li;Li Shiyu;Zhuang Hongdi;Yin Weijia(Department of Nosocomial Infection Control;Department of Neurosurgery , West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院医院感染管理部,成都610041 [2]四川大学华西医院医院神经外科,成都610041

出　　处：《中华流行病学杂志》2018年第7期988-992,共5页Chinese Journal of Epidemiology

摘　　要：目的研究神经外科肿瘤患者术后感染对住院日和住院费用的影响。方法以2015年7月1日至2017年6月30日神经外科肿瘤术后患者为研究对象，在院发生术后感染患者为病例组，未发生感染者为对照组，按住院时间（±3月）、年龄（±5岁）及手术部位进行1：1配对，比较两组平均住院日和各项医疗费用。结果神经外科肿瘤患者术后感染率为5．66％，以手术部位感染（54．72％）和下呼吸道感染（31．32％）为主；病例组平均住院日为20．5d，较对照组延长8．5d（z=-10．618，P〈0．001）；病例组平均费用为91573．42元，较对照组增加30518．17元（z=-9．988，P〈0．001）；其中手术部位感染和下呼吸道感染患者平均费用分别为84888．50元和110442．64元，较对照组分别增加23627．49元（z=-6．627，P〈O．001）和43631．36元（z=-4．954，P〈0．001）。结论术后感染将延长患者住院日并增加住院费用，影响医院的社会效益和经济效益，应引起各级医院的高度重视。Objective To investigate the influence of postoperative infection on average hospitalization days and medical costs in patients with nervous system tumor. Methods The tumor patients treated in neurosurgery ward from July 1, 2015 to June 30, 2017 were included in the study. The patients with and without postoperative infections were divided into a case group and a control group, respectively （1 ： 1 ratio）, matched by admission time （± 3 months）, age （± 5 years） and surgical site. Average hospitalization days and medical costs between the two groups were analyzed. Results The incidence of postoperative infection was 5.66%, the surgical site infection and lower respiratory tract infection accounted for 54.72% and 31.32% of the total, respectively. The median of hospitalization days in the case group was 20.5, 8.5 days longer than that in the control group （Z= -10.618, P〈0.001）. The median of total medical costs in the case group was 91 573.42 yuan, higher than that of the control group by 30 518.17 yuan （Z=-9.988, P〈0.001）. The average costs of surgical and lower respiratory tract infection were 84 888.50 yuan and 110 442.64 yuan, respectively. Among them, surgical site infection or lower respiratory tract infection caused the extra cost of 23 627.49 yuan （Z=-6.627, P〈0.001） and 43 631.36 yuan （Z=-4.954, P〈0.001）, respectively. Conclusions Postoperative infection greatly increased the patient＇ s financial burden, prolonged the hospitalization duration and resulted in unnecessary use of health resources. It is necessary to pay close attention to postoperative infection.

关 键 词：神经外科 肿瘤 术后感染 住院日 住院费用 

分 类 号：R197.32[医药卫生—卫生事业管理] R739.4[医药卫生—公共卫生与预防医学]