The cost of infection in hip arthroplasty: A matched case–control study

Abstract

ObjectiveSurgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case–control study in acute-term care at Ramon y Cajal University Hospital in Spain. Material and methodCases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anaesthesiologists score, age, sex, surgery date, and principal diagnosis. ResultsThis study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. ConclusionsSSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.