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Impact of acute kidney injury on mortality and medical costs in patients with meticillin-resistant Staphylococcus aureus bacteraemia: a retrospective, multicentre observational study

 E.-J. Joo  ;  K.R. Peck  ;  Y.E. Ha  ;  Y.-S. Kim  ;  Y.-G. Song  ;  S.-S. Lee  ;  S.-Y. Ryu  ;  C. Moon  ;  C.-S. Lee  ;  K.-H. Park 
 JOURNAL OF HOSPITAL INFECTION, Vol.83(4) : 300-306, 2013 
Journal Title
Issue Date
Acute Kidney Injury/economics ; Acute Kidney Injury/mortality* ; Acute Kidney Injury/therapy* ; Adult ; Aged ; Aged, 80 and over ; Bacteremia/complications ; Bacteremia/economics ; Bacteremia/mortality* ; Female ; Health Care Costs* ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/isolation & purification* ; Middle Aged ; Retrospective Studies ; Staphylococcal Infections/complications ; Staphylococcal Infections/economics ; Staphylococcal Infections/mortality* ; Survival Analysis
Acute kidney injury ; Costs ; Meticillin resistance ; Staphylococcus aureus
BACKGROUND: Despite the frequent occurrence of acute kidney injury (AKI) associated with meticillin-resistant Staphylococcus aureus (MRSA) infection during treatment, the adverse impact of renal injury on clinical and economic outcomes has not been evaluated. AIM: To study the clinical and economic burdens of MRSA bacteraemia and the impact of AKI occurring during treatment on outcomes. METHODS: Medical records of patients hospitalized for MRSA bacteraemia between March 2010 and February 2011 in eight hospitals in Korea were reviewed retrospectively to evaluate the risk factors for AKI and mortality. Direct medical costs per patient of MRSA bacteraemia during treatment were estimated from the medical resources consumed. FINDINGS: In all, 335 patients were identified to have MRSA bacteraemia. AKI occurred in 135 patients (40.3%) during first-line antibiotic therapy. Independent risk factors for AKI were male sex, underlying renal disease, intra-abdominal and central venous catheter infection, and increase in Pitt bacteraemia score. Seventy-seven (23.0%) patients died during the study period. Underlying solid tumour, high Pitt bacteraemia score, and occurrence of AKI were independent risk factors for mortality. The mean total medical cost per MRSA patient was estimated as South Korean Won 5,435,361 (US$4,906), and occurrence of AKI and ICU admission were identified as independent predictors of increased direct medical costs. Compared with patients who retained their baseline renal function, patients with AKI had a 45% increase in medical costs. CONCLUSIONS: Patients who developed AKI showed significantly higher mortality rate and greater direct medical costs compared with patients who retained baseline renal function.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
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