The goal of this study was to evaluate the impact of bacteremia complicating SSSIs on length of hospital stay and costs.<h4 class=""h4"">Methodsh4>
This was a retrospective cohort study involving 579 patients with culture-positive SSSIs who were admitted to Barnes-Jewish Hospital, a major academic medical center, between April 1, 2005, and December 31, 2007. The outcomes evaluated in this analysis included hospital mortality, length of stay, hospital costs, and hospital readmission.<h4 class=""h4"">Resultsh4>
Secondary bacteremia was present in 277 (47.8 % ) patients. Hospital mortality was statistically greater among patients with bacteremia (7.9 % vs 1.0 % ; P < 0.001). The unadjusted median length of stay in bacteremic patients was 7.1 days compared with 2.8 days in those without bacteremia (P < 0.001 by log-rank test). This finding correlated with total hospital costs, which were greater in patients with bacteremia (median values: $14,623 vs $5841.50; P < 0.001). In a Cox model controlling for multiple confounders, bacteremia independently correlated with hospital duration (adjusted hazard ratio [HR], 1.820; 95 % CI, 1.654?.003; P < 0.001) and hospital costs (adjusted HR, 1.895; 95 % CI, 1.723?.083; P < 0.001). Hospital readmission within 30 days of discharge was also significantly more common among patients with SSSIs complicated by bacteremia (24.5 % vs 12.9 % ; P < 0.001).<h4 class=""h4"">Conclusionsh4>
Bacteremia complicating SSSIs occurred in almost 50 % of patients infected with gram-positive bacteria in our institution. Beyond its impact on mortality, bacteremia is associated with increased length of stay, hospital costs, and readmission. However, these data are from a single academic medical center and may not be adjusted for all applicable confounders.