Healthcare-associated infection in a thoracic surgery ICU based on case mix index and relative weight of diagnosis-related groups
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1.Office of Healthcare-associated Infection Management, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;2.Center for Statistics, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;3.Hospital Office, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China

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    Abstract:

    Objective To explore the correlation between healthcare-associated infection (HAI) and partial indexes in the diagnosis-related groups (DRGs) of patients in thoracic surgery intensive care unit (ICU). Methods DRGs, case mix index (CMI), relative weight (RW), and HAI of patients in thoracic surgery ICU and four subspecialty departments (pulmonary surgery group, esophageal surgery group, mediastinum group [mainly thymic surgery], and trachea group) in a tertiary chest hospital in Shanghai from January to December 2022 were retrospectively analyzed and compared through DRGs index grouping. Results A total of 1 429 patients in the department of thoracic surgery ICU were analyzed, including 59 HAI cases, with a HAI rate of 4.13%. The incidences of HAI in pulmonary surgery group, esophageal surgery group, mediastinum group and trachea group were 3.74% (30/803), 5.84% (25/428), 1.27% (2/157) and 4.88% (2/41), respectively. There was no statistically significant difference in the incidences of HAI among different subspecialty groups (P>0.05). A total of 35 DRGs were involved, with CMI of 2.75, 3.41, 2.35 and 1.25 in pulmonary surgery group, esophageal surgery group, mediastinum group and trachea group, respectively, and RW ranged from 0.53 to 12.62. In the pulmonary surgery group, incidence of HAI in male patients was higher than that in female patients. Higher RW score level was associated with higher incidence of HAI. Differences were all statistically significant (all P < 0.05). Among patients in the esophageal surgery group, the age of HAI group was higher than that of the non-HAI group (P < 0.05). Higher RW score level was associated with higher incidence of HAI (P < 0.05). Among patients in the mediastinum surgery group, the age of patients in the infected group was higher than that in the non-infected group (P < 0.05). Among the 59 HAI cases, 31 were infected with MDROs. Conclusion Focusing on CMI and RW in the DRGs index system, analyzing HAI from the perspectives of disease complexity and overall technical difficulties of medical services can provide reference for the precise management of HAI in the new era.

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纪灏,刘媛,于佳,等.基于DRGs病例组合指数和相对权重的胸外科ICU医院感染研究[J].中国感染控制杂志英文版,2024,23(1):78-85. DOI:10.12138/j. issn.1671-9638.20244529.
Hao JI, Yuan LIU, Jia YU, et al. Healthcare-associated infection in a thoracic surgery ICU based on case mix index and relative weight of diagnosis-related groups[J]. Chin J Infect Control, 2024,23(1):78-85. DOI:10.12138/j. issn.1671-9638.20244529.

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  • Received:May 24,2023
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  • Online: April 28,2024
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