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Excess Mortality, Hospital Stay, and Cost Due to Candidemia: A Case-Control Study Using Data From Population-Based Candidemia Surveillance

Published online by Cambridge University Press:  21 June 2016

Juliette Morgan ,
Martin I. Meltzer ,
Brian D. Plikaytis ,
Andre N. Sofair ,
Sharon Huie-White ,
Steven Wilcox ,
Lee H. Harrison ,
Eric C. Seaberg ,
Rana A. Hajjeh  and
Steven M. Teutsch
Juliette Morgan*
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Martin I. Meltzer
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Brian D. Plikaytis
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Andre N. Sofair
Affiliation:
Yale University School of Medicine, New Haven, Connecticut
Sharon Huie-White
Affiliation:
Yale University School of Medicine, New Haven, Connecticut
Steven Wilcox
Affiliation:
ChimeData, Wallingford, Connecticut
Lee H. Harrison
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Eric C. Seaberg
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Rana A. Hajjeh
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Steven M. Teutsch
Affiliation:
Outcomes and Research Management, Merck & Co., Inc., West Point, Pennsylvania
*
Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail-stop C-09, Atlanta, GA 30333.JMorgan1@cdc.gov
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Abstract

Objective:

To determine the mortality, hospital stay, and total hospital charges and cost of hospitalization attributable to candidemia by comparing patients with candidemia with control-patients who have otherwise similar illnesses. Prior studies lack broad patient and hospital representation or cost-related information that accurately reflects current medical practices.

Design:

Our case-control study included case-patients with candidemia and their cost-related data, ascertained from laboratory-based candidemia surveillance conducted among all residents of Connecticut and Baltimore and Baltimore County, Maryland, during 1998 to 2000. Control-patients were matched on age, hospital type, admission year, discharge diagnoses, and duration of hospitalization prior to candidemia onset.

Results:

We identified 214 and 529 sets of matched case-patients and control-patients from the two locations, respectively. Mortality attributable to candidemia ranged between 19% and 24%. On multivariable analysis, candidemia was associated with mortality (OR, 5.3 for Connecticut and 8.5 for Baltimore and Baltimore County; P < .05), whereas receiving adequate treatment was protective (OR, 0.5 and 0.4 for the two locations, respectively; P < .05). Candidemia itself did not increase the total hospital charges and cost of hospitalization; when treatment status was accounted for, having received adequate treatment for candidemia significantly increased the total hospital charges and cost of hospitalization ($6,000 to $29,000 and $3,000 to $22,000, respectively) and the length of stay (3 to 13 days).

Conclusion:

Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment (Infect Control Hosp Epidemiol 2005;26:540-547).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 6 , June 2005 , pp. 540 - 547
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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