The economic implications of infection in cardiac surgery

To assess the economic impact of infection, the records of 496 patients aged 18 to 82 years (mean, 61 years) undergoing open-heart operations in 1981 and 1982 were reviewed, and the costs (length of stay, hospital charges, pharmacy charges) were compared for matched pairs of patients with and without infection who had coronary artery bypass grafting (CABG) procedures. Patients received a 5-day regimen of prophylactic cephalosporin. Operative site infections occurred within 6 months of operation in 17 patients (3.4%), urinary tract infections in 9 (1.8%), and pulmonary infections in 6 (1.2%). Early and late mortality was each 2%. No deaths were infection related, and no postoperative bacterial endocarditis occurred (minimum one-year follow-up). For the matched CABG patient in whom a postoperative wound infection developed, the average length of hospital stay was 16.7 days longer and the average hospital bill was $8,118 greater, with the average cost to the hospital $6,605 greater.