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目的:极低体重儿(VLBW)的院内血源性感染(NBISs)常导致病情加重及住院时间延长(LOS)。事实上,此前还没有根据不同的出生体重(BW)分组研究感染引起的治疗成本和住院时间增加的报道。本研究的目的是测算不同体重的VLBW由NBISs所导致的LOS及边缘成本增加。方法:笔者对来自于2000年新生儿重症监护质量促进合作组及佛蒙特洲牛津合作组的临床资料进行了回顾性研究。使用一元分析及多元回归方法来调查NBISs对医院成本及住院时间的影响。2000年新生儿重症监护质量促进合作组的17个新生儿重症监护单位将1998年1月1日至1999年12月31日出生的VLBW的临床及治疗费用资料都提交给了本研究。这些研究包括从大学到社区医院。结果:在2809例患儿中, 19.7%发生NBISs。对出生时体重在751 g到1500 g的患儿,NBISs导致治疗费用的显著增加。通过多元回归分析,对于出生时体重为401-750 g的VLBW,NBISs 的边缘成本为5875美元。而出生时体重为751- 1000g的患儿则为12480美元。所有的出生体重组住院时间都显著延长。通过多元回归分析,出生时体重为1001-1251 g的VLBW的住院时间增加了4d,而体重为751-1000 g的患儿则增加了7 d。结论:NBISs会导致治疗费用增加和住院期延长,其影响大小取决于患儿出生时体重。仅预防极低体重儿VLBW就可
OBJECTIVE: In-hospital blood-borne infections (NBISs) in very low birth weight infants (VLBW) often result in exacerbations and prolonged hospitalization (LOS). In fact, there have been no reports of treatment costs and length of hospital stay that have been investigated for infections based on different birth weight (BW) groups. The purpose of this study was to determine the increase in LOS and edge costs caused by NBISs for VLBW of different weights. METHODS: The authors conducted a retrospective review of the clinical data from the Cooperative Group for Neonatal Intensive Care Quality Improvement 2000 and the Vermont Partnership Oxford. Univariate analysis and multivariate regression were used to investigate the impact of NBISs on hospital costs and length of stay. Seventeen newborn ICU units in the 2000 Neonatal Intensive Care Quality Cooperation Unit submitted clinical and treatment cost data for VLBW, born between January 1, 1998 and December 31, 1999, to this study. These studies range from universities to community hospitals. Results: Of 2809 children, 19.7% developed NBISs. NBISs result in a significant increase in the cost of treatment for children born at 751 g to 1500 g at birth. By multivariate regression analysis, the marginal cost of NBISs was $ 5,875 for VLBW weighing 401-750 g at birth. The birth weight of 751 - 1000g of children was 12480 US dollars. All birth weight groups had significantly longer hospital stays. By multivariate regression analysis, the length of hospital stay increased by 4 days in VLBW with birth weight of 1001-1251 g, and 7 days with 751-1000 g in weight. CONCLUSIONS: NBISs lead to increased cost of treatment and prolonged hospital stay, the magnitude of which depends on the weight of the child at birth. Only VLGW for very low birth weight children can be prevented