Neonatal XXXX : Effects of Bloodstream Infections on Outcomes and Costs.

@entity1 @entity1699 @entity600 @entity86 @entity299 @entity580
BACKGROUND: @entity1699 ( @entity1699 ) is not only a devastating disease, but also the most expensive @entity600 managed in the US. @entity580 ( @entity580 ) are common in neonates with @entity1699 . We examined the effects of @entity580 on in-hospital mortality, length of stay, and costs for late preterm and term @entity1 with @entity1699 undergoing stage 1 palliation, at both individual @entity1 and hospital levels. METHODS: We conducted a retrospective study of @entity1 35 weeks or greater gestation with @entity1699 , admitted to our institution January 1, 2003 to January 1, 2013. @entity1 with other @entity299 , major comorbid conditions, or perinatal infections were excluded. Univariable and multivariable analyses were performed. To estimate the effects of reduced NBI incidence on resource utilization, predictive models were used. RESULTS: One hundred forty-three @entity1 met inclusion criteria. In-hospital mortality was 9.1% (n  = 13). @entity86 was observed in 12.6% (n  = 18). Median length of stay was 23 days for survivors (IQR, 17 to 40; range, 9 to 132). Median costs were  83,000 for survivors, in 2013 dollars (IQR,  62,000 to  123,000; range,  17,000 to  517,000). @entity580 were not associated with changes in mortality. In multivariable analyses, at a @entity1 level @entity580 were associated with a 74% increase in length of stay (95% confidence interval [CI], 31% to 132%, p < 0.001) and a 65% increase in costs (95% CI, 28% to 114%, p < 0.001). On a hospital level, in this cohort a 50% reduction in the incidence of @entity580 would be expected to yield a 4.3% decrease in average length of stay and a 3.8% decrease in average in- @entity1 costs. CONCLUSIONS: @entity580 in neonates with @entity1699 are associated with large increases in lengths of stay and costs on a @entity1 level, but not a hospital level. For hospitals without particularly high incidences, studies are needed to identify additional targets for quality improvement.
