PMID- 31830394
OWN - NLM
STAT- MEDLINE
DCOM- 20200528
LR  - 20200528
IS  - 1724-5990 (Electronic)
IS  - 0393-5590 (Linking)
VI  - 36
IP  - 6
DP  - 2019 Dec 9
TI  - [Economic impact of kidney patients with sepsis in hospital setting].
LID - 2019-vol6 [pii]
AB  - Introduction: Over the last decades, sepsis has become a real medical emergency, 
      with a high mortality rate and often requiring admission to an intensive care 
      unit. An increasing number of CKD patients contracts sepsis due to several 
      clinical risk factors (use of catheters, immunosuppressive therapy, comorbidity, 
      etc.) and is treated in Nephrology wards, generating additional costs that are 
      not covered by hospital Diagnosis Related Groups (DRG) reimbursement. The aim of 
      the study is to evaluate the costs of sepsis in one Nephrology Unit and to detect 
      the mortality rate of CKD patients with sepsis. Methods: We conducted a 
      retrospective study on a cohort of CKD patients admitted into one Nephrology Unit 
      in 2017. CKD inpatients were divided in two groups: patients with sepsis (SP) and 
      without (control group). Socio-demographic, clinical and therapeutic data, as 
      well as routine biochemistry, were collected through a "sepsis form". SP were 
      identified thanks to hospital discharge records (HDR). The hospital-related costs 
      of a SP were obtained by summing up: (1) the average cost of an inpatient day of 
      care for the average length of stay in the Nephrology Unit; (2) the average cost 
      of the antimicrobial therapy, as recorded on the clinical folder. Results: Among 
      the 408 CKD inpatients, 61 were septic. The overall average cost of a SP was 
      23.087,57 euro; the average cost of the hospital stay and of the antimicrobial 
      therapy was 19.364,98 euro and 3.722,60 euro respectively. The average length of stay 
      in the Nephrology Unit was 16.7 days. The in-hospital mortality rate was 41.7%, 
      with a 312% additional mortality rate. Conclusions: SP had an overall average 
      cost three times higher than CKD inpatients without sepsis (9.290,79 euro). This 
      additional cost was due to a longer hospital stay (8.7 days more on average) and 
      a higher cost of antimicrobial therapy per case (euro 221,24). A national 
      multi-centre study is needed to confirm our data and to promote an adjustment of 
      reimbursement tariff for DRG-sepsis, which is now applicable only to an ICU 
      setting.
CI  - Copyright by Societa Italiana di Nefrologia SIN, Rome, Italy.
FAU - Battaglia, Yuri
AU  - Battaglia Y
AD  - UOC di Nefrologia e Dialisi, AOU "Sant'Anna", Ferrara, Italia.
FAU - Guerzoni, Franco
AU  - Guerzoni F
AD  - Nucleo Aziendale Controlli, AOU "Sant'Anna", Ferrara, Italia.
FAU - Gigante, Manuel
AU  - Gigante M
AD  - UOC di Nefrologia e Dialisi, AOU "Sant'Anna", Ferrara, Italia.
FAU - Veronesi, Marco
AU  - Veronesi M
AD  - UOC di Nefrologia e Dialisi, AOU "Sant'Anna", Ferrara, Italia.
FAU - Oppi, Chiara
AU  - Oppi C
AD  - Dipartimento di Economia e Management, Universita di Ferrara, Italia.
FAU - Forini, Elena
AU  - Forini E
AD  - Ufficio Statistico, AOU "Sant'Anna", Ferrara, Italia.
FAU - Ullo, Ines
AU  - Ullo I
AD  - UOC di Nefrologia e Dialisi, ASST Sette Laghi, Varese, Italia.
FAU - Vagnoni, Emidia
AU  - Vagnoni E
AD  - Dipartimento di Economia e Management, Universita di Ferrara, Italia.
FAU - Storari, Alda
AU  - Storari A
AD  - UOC di Nefrologia e Dialisi, AOU "Sant'Anna", Ferrara, Italia.
LA  - ita
PT  - Journal Article
DEP - 20191209
PL  - Italy
TA  - G Ital Nefrol
JT  - Giornale italiano di nefrologia : organo ufficiale della Societa italiana di 
      nefrologia
JID - 9426434
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - *Health Care Costs
MH  - Hospitalization/*economics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Renal Insufficiency, Chronic/complications/*economics/*therapy
MH  - Retrospective Studies
MH  - Sepsis/complications/*economics/*therapy
OTO - NOTNLM
OT  - costs
OT  - hospital discharge register
OT  - kidney disease
OT  - sepsis
EDAT- 2019/12/13 06:00
MHDA- 2020/05/29 06:00
CRDT- 2019/12/13 06:00
PHST- 2019/12/13 06:00 [entrez]
PHST- 2019/12/13 06:00 [pubmed]
PHST- 2020/05/29 06:00 [medline]
AID - 36-06-2019-8 [pii]
PST - epublish
SO  - G Ital Nefrol. 2019 Dec 9;36(6):2019-vol6.