Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit

Christine S Cocanour, Luis Ostrosky-Zeichner, Michelle Peninger, Debbi Garbade, Tommy Tidemann, Bradley D. Domonoske, Tao Li, Steven J. Allen, Katharine M. Luther

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Background: Nosocomial pneumonia and especially ventilator-associated pneumonia (VAP) are costly complications for the hospitalized patient. Nosocomial pneumonia has been estimated to cost $5,000 per episode, but the specific cost for a VAP has not been well estimated. As part of a successful performance improvement program in decreasing VAP from 10 VAPs/100 ICU admissions to 2.5 VAPs/100 ICU admissions, we examined the costs associated with VAP. Methods: From January 1, 2002, through September 30, 2003, Shock Trauma Intensive Care Unit patients and charts were reviewed concurrently by an infection control practitioner for development of VAP as defined by National Nosocomial Infection Surveillance (NNIS) guidelines. Costs were obtained from the hospital's cost accounting software Transition Systems version 3.1.01 (TSI). All patients requiring greater than one day of mechanical ventilation were evaluated. Seventy patients with VAP and 70 patients without VAP were matched according to age and Injury Severity Score. Differences were compared using Kruskal-Wallis and two-sample T-tests. Significance was considered for p < 0.05. Results: The ICU cost difference was significant (p < 0.05) between the case-controlled patients with VAP ($82,195) and those without VAP ($25,037). There was also a significant increase in ICU length of stay (21.6 versus 6.4 days) and the number of ventilator days (17.7 versus 5.8; both, p < 0.05). Mortality was not different in the case-controlled population. A substantial portion of the increased cost of a VAP was from the increase in ICU length of stay ($1,861/day). Pharmacy, respiratory and "other" also accounted for the increases when cost distribution was analyzed. This translates into a cost avoidance of approximately $428,685 per 100 admissions to the ICU. Conclusions: Ventilator-associated pneumonia not only leads to a significant increase in ventilator days and ICU length of stay, but adds substantially to hospital costs. In our ICU, an episode of VAP costs $57,000 per occurrence.

Original languageEnglish (US)
Pages (from-to)65-72
Number of pages8
JournalSurgical Infections
Volume6
Issue number1
DOIs
StatePublished - Mar 2005
Externally publishedYes

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Ventilator-Associated Pneumonia
Intensive Care Units
Shock
Costs and Cost Analysis
Wounds and Injuries
Length of Stay
Hospital Costs
Mechanical Ventilators
Pneumonia
Infection Control Practitioners
Injury Severity Score
Cross Infection
Artificial Respiration
Software

ASJC Scopus subject areas

  • Surgery
  • Microbiology (medical)

Cite this

Cocanour, C. S., Ostrosky-Zeichner, L., Peninger, M., Garbade, D., Tidemann, T., Domonoske, B. D., ... Luther, K. M. (2005). Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit. Surgical Infections, 6(1), 65-72. https://doi.org/10.1089/sur.2005.6.65

Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit. / Cocanour, Christine S; Ostrosky-Zeichner, Luis; Peninger, Michelle; Garbade, Debbi; Tidemann, Tommy; Domonoske, Bradley D.; Li, Tao; Allen, Steven J.; Luther, Katharine M.

In: Surgical Infections, Vol. 6, No. 1, 03.2005, p. 65-72.

Research output: Contribution to journalArticle

Cocanour, CS, Ostrosky-Zeichner, L, Peninger, M, Garbade, D, Tidemann, T, Domonoske, BD, Li, T, Allen, SJ & Luther, KM 2005, 'Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit', Surgical Infections, vol. 6, no. 1, pp. 65-72. https://doi.org/10.1089/sur.2005.6.65
Cocanour CS, Ostrosky-Zeichner L, Peninger M, Garbade D, Tidemann T, Domonoske BD et al. Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit. Surgical Infections. 2005 Mar;6(1):65-72. https://doi.org/10.1089/sur.2005.6.65
Cocanour, Christine S ; Ostrosky-Zeichner, Luis ; Peninger, Michelle ; Garbade, Debbi ; Tidemann, Tommy ; Domonoske, Bradley D. ; Li, Tao ; Allen, Steven J. ; Luther, Katharine M. / Cost of a ventilator-associated pneumonia in a shock trauma intensive care unit. In: Surgical Infections. 2005 ; Vol. 6, No. 1. pp. 65-72.
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AU - Ostrosky-Zeichner, Luis

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AU - Tidemann, Tommy

AU - Domonoske, Bradley D.

AU - Li, Tao

AU - Allen, Steven J.

AU - Luther, Katharine M.

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N2 - Background: Nosocomial pneumonia and especially ventilator-associated pneumonia (VAP) are costly complications for the hospitalized patient. Nosocomial pneumonia has been estimated to cost $5,000 per episode, but the specific cost for a VAP has not been well estimated. As part of a successful performance improvement program in decreasing VAP from 10 VAPs/100 ICU admissions to 2.5 VAPs/100 ICU admissions, we examined the costs associated with VAP. Methods: From January 1, 2002, through September 30, 2003, Shock Trauma Intensive Care Unit patients and charts were reviewed concurrently by an infection control practitioner for development of VAP as defined by National Nosocomial Infection Surveillance (NNIS) guidelines. Costs were obtained from the hospital's cost accounting software Transition Systems version 3.1.01 (TSI). All patients requiring greater than one day of mechanical ventilation were evaluated. Seventy patients with VAP and 70 patients without VAP were matched according to age and Injury Severity Score. Differences were compared using Kruskal-Wallis and two-sample T-tests. Significance was considered for p < 0.05. Results: The ICU cost difference was significant (p < 0.05) between the case-controlled patients with VAP ($82,195) and those without VAP ($25,037). There was also a significant increase in ICU length of stay (21.6 versus 6.4 days) and the number of ventilator days (17.7 versus 5.8; both, p < 0.05). Mortality was not different in the case-controlled population. A substantial portion of the increased cost of a VAP was from the increase in ICU length of stay ($1,861/day). Pharmacy, respiratory and "other" also accounted for the increases when cost distribution was analyzed. This translates into a cost avoidance of approximately $428,685 per 100 admissions to the ICU. Conclusions: Ventilator-associated pneumonia not only leads to a significant increase in ventilator days and ICU length of stay, but adds substantially to hospital costs. In our ICU, an episode of VAP costs $57,000 per occurrence.

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