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Vol. 9. Issue 2.
Pages 108-114 (January 1998)
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Vol. 9. Issue 2.
Pages 108-114 (January 1998)
Estimación del coste económico atribuible a la infección postoperatoria en neurocirugía
Evaluation of economic cost due to postoperative infection in neurosurgery
V. Gilete, P. Parés, J. Molet, B. Oliver, P. Tresserras, F. Bartumeus
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Facultad de Medicina de la Universidad Autónoma de Barcelona
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Resumen

La infección postquirúrgica comporta un aumento en el tiempo de estancia hospitalaria. Mediante un estudio observacional prospectivo se evaluó el coste económico atribuible a la infección postoperatoria en neurocirugía en base al aumento de estancia hospitalaria achacable a ésta. Se identificaron 64 pacientes que sufrieron 73 episodios de infección postoperatoria sobre un total de 832 enfermos que se sometieron a 1.080 intervenciones durante un período de 28 meses.

La comparación de la estancia hospitalaria cuando la intervención quirúrgica no se afectó de una infección postoperatoria con respecto a cuando sí la hubo, demostró que las permanencias hospitalarias en los casos con infección postoperatoria eran 21 días mayores (de mediana) que en los casos sin infección (p0,001), hecho que comporta un gasto extra mínimo en base a la estancia hospitalaria de 549.000 pesetas/1996 por episodio infeccioso. De acuerdo con los resultados obtenidos, una infección de herida podría suponer un gasto adicional de hasta 579.000 ptas./1996; un paciente sometido a intervención de columna e infectado podría comportar un coste extra de 1.098.000 ptas./1996. Sin olvidar las consecuencias en forma de morbimortalidad, la infección postquirúrgica en neurocirugía se demuestra cara. Sólo la aplicación de las medidas preventivas conocidas, entre las que se incluye un programa de vigilancia y control de la infección postoperatoria en neurocirugía, permitiría una reducción del gasto total atribuible a ésta, que implicaría un ahorro considerable para nuestro sistema sanitario.

Palabras clave:
Neurocirugía
Infección postoperatoria
Coste económico
Summary

Postsurgical infection in neurosurgery implies a prolongation of hospital stay. The objective of this study is to estimate the attributable cost of postsurgical infection, based on the increase of hospital stay due to infection. Sixty-four patients suffered 73 infections episodes in a population of 832 patients who underwent 1.080 operations during 28 months. The comparison of stay between the operations that were no affected by infection and the ones that suffered postoperative infection, showed 21 extra days of hospital stay (median) in the infected cases (p0,001), implying an extra cost based on hospital stay of 549.000 pesetas/1996 by infectious episode. In accordance to the obtained results, a wound infection would imply an extra charge of 579.000 pesetas/1996, and 1.098.000 pesetas/1996 if a spine operation was infected. Postneurosurgical infection is expensive. The application of recognized preventive measures, such as infection surveillance and control programs of postoperative infection, would lower the total cost atributable to infection and be a saving for the public health system.

Key words:
Economics
Cost
Neurosurgical infection

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