脑卒中手术患者医院感染发生率及经济负担分析  

Prevalence of nosocomial infections in stroke patients undergoing surgical procedures and economic burden

作　　者：李亚婷[1,2] 阎田园 王书会 刘晨霞[1,2] 周薇 LI Ya-ting;YAN Tian-yuan;WANG Shu-hui;LIU Chen-xia;ZHOU Wei(Qilu Hospital of Shandong University,Jinan,Shandong 250012,China)

机构地区：[1]山东大学齐鲁医院感染管理处,山东济南250012 [2]山东大学护理学院,山东济南250012 [3]济南市传染病医院感染管理科,山东济南250021

出　　处：《中华医院感染学杂志》2018年第18期2796-2798,2806,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2018MG015)

摘　　要：目的调查脑卒中手术患者医院感染发生率及经济负担,为卫生决策部门制定相关政策提供依据。方法对2016年1月1日-2017年12月31日某三级甲等医院神经外科病房脑卒中手术患者医院感染情况进行调查,并采用1∶1病例对照研究方法,运用秩和检验比较感染组和非感染组的住院费用和住院天数,计算医院感染造成的经济负担。结果纳入的466例脑卒中手术病人中,133例发生医院感染,感染发生率为28.54%。感染组患者住院费用中位数为126280.08元,非感染组为72333.87元,两组比较差异有统计学意义(Z=-6.698,P<0.001),医院感染的直接经济负担为53946.21元;感染组住院天数中位数为19d,非感染组为13d,两组比较差异有统计学意义(Z=-6.726,P<0.001),医院感染延长病人住院6d;造成的间接经济负担为2055.6元,合计医院感染经济负担为56001.81元。结论脑卒中手术患者发生医院感染后住院费用增加,住院时间延长,给患者造成巨大的经济负担。OBJECTIVE To investigate the incidence of nosocomial infections in stroke patients undergoing surgical procedures and analyze the economic burden so as to provide guidance for development of related policies.METHODS The prevalence of nosocomial infections in the stroke patients who underwent surgical procedures in wards of neurosurgery departments of a three-A tertiary hospital from Jan 1,2016 to Dec 31,2017 was investigated.By means of a 1∶1 ratio of case-control study,the chi-square test was performed to compare the length of hospital stay and hospitalization costs between the infection group and the non-infection group,and the economic burden due to the nosocomial was calculated.RESULTS Of the 466 enrolled stroke patients,133 had nosocomial infection,with the infections rate 28.54%.The median hospitalization cost was 126280.08 yuan in the infection group,72333.87 yuan in the non-infection group,and there was significant difference between the two groups（Z=-6.698,P〈0.001）.The direct economic burden due to nosocomial infections was 53946.21 yuan,the median length of hospital stay was 19 days in the infection group,13 days in the non-infection group,and there was significant difference between the two groups（Z=-6.726,P〈0.001）.The length of hospital stay of the patients extended by 6 days due to the nosocomial infections;the indirect economic burden was 2055.6 yuan due to the nosocomial infections,and the total economic burden was 56001.81 yuan due to the nosocomial infections.CONCLUSIONThe nosocomial infections in the stroke patients undergoing surgical procedures may lead to the increase of hospitalization cost and extension of length of hospital stay and bring tremendous economic burden to the patients.

关 键 词：脑卒中 外科手术 医院感染 经济负担 

分 类 号：R619[医药卫生—外科学]