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ICU Infection Prevention Saves Lives and Money

October 12th, 2016

NEW YORK – Here’s even more motivation to prevent nosocomial infections in the intensive care unit: Elderly patients admitted to ICUs are about 35% more likely to die within five years of leaving the hospital if they develop an infection during their stay.

That’s according to a study published recently in the American Journal of Infection Control. It further notes that prevention of two of the most common health care-acquired infections – sepsis related to central lines and pneumonia related to ventilators – not only increases the survival odds of the patents but also reduces the cost of their care by more than $150,000.

"Any death from preventable infections is one too many," said senior author Patricia Stone, PhD, RN, FAAN, director of the Center for Health Policy at Columbia University School of Nursing. "We've known for decades what works to prevent infections and save lives. Now, our study shows just how much money can be saved by investing in prevention."

For the study, researchers focused on infection prevention efforts and outcomes for 17,537 elderly Medicare patients admitted to 31 hospitals in 2002. An additional five years of Medicare claims data was then used to assess the long-term outcomes and health costs attributed to healthcare-acquired infections.

Overall, 57% of all the elderly ICU patients died within five years, but researchers found that previous ICU infections made death more likely. Of those who had developed central line-associated bloodstream infections (CLABSI), 75% died within five years. The rate was even higher for those who developed ventilator-associated pneumonia (VAP): 77% of those patients died during the time period.

With effective prevention programs for CLABSI, however, ICU patients in general gained 15.55 years of life on average. Infection prevention can be as simple as hand washing before handling the catheter and immediately changing the dressing around the central line if it gets wet or dirty according to the study.

Meanwhile, measures to prevent VAP resulted in an estimated gain of 10.84 years of life on average for all patients treated in the ICU. Again, the study cites basic procedures such as keeping patients elevated in bed, with the head higher than the feet, as simple precautions that can help prevent pneumonia.

With the ongoing cost of running an infection prevention program in the ICU is estimated to be about $145,000, the study found that prevention efforts reduced ICU costs by $174,713 per patient for each instance of CLABSI, and by $163,090 for VAP.

"This evidence points definitively to the value of investing in infection prevention," said lead study author Andrew Dick, PhD, senior economist at RAND Corporation.