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Table 2 Patient characteristics, clinical and economic outcomes

From: The healthcare costs of antimicrobial resistance in Lebanon: a multi-centre prospective cohort study from the payer perspective

  Healthcare-associated infections Community-associated infections
  Post-HAI method Matched Method Conventional method
  Resistant Susceptible p-values Resistant Susceptible p-values Resistant Susceptible p-values
No. 374 283   238 238   299 333  
Characteristics prior to infection
Age (median [IQR]) 69 (56–80) 67 (52–78) 0.174 67 (55–80) 68 (53–79) 1.000 81 (69–85) 70 (46–79) 0.152
Female sex 170 (45%) 135 (48%) 0.311 105 (44%) 117 (49%) 0.156 152 (51%) 191 (57%) 0.059
Previous hospitalizationa 250 (67%) 182 (64%) 0.276 169 (71%) 147 (62%) 0.021 1.000
Transfer from another healthcare facility 22 (6%) 18 (6%) 0.462 15 (6%) 14 (6%) 0.500  
Invasive surgery 124 (33%) 80 (28%) 0.104 74 (31%) 73 (31%) 0.500 66 (22%) 60 (18%) 0.120
Charlson Co-morbidity Index (median [IQR]) 4 (3–6) 4 (2–6) 0.205 4 (3–6) 4 (2–6) 0.854 6 (5–8) 5 (1–6) 0.002
Previous antibiotic exposurea 67 (18%) 35 (12%) 0.032 46 (19%) 32 (13%) 0.054 52 (17%) 36 (1%) 0.012
Infection and patient outcomes
A-Clinical parameters
ICU admission 124 (33%) 75 (26%) 0.040 70 (29%) 60 (25%) 0.177 66 (22%) 39 (12%) < 0.001
ICU days (median [IQR]) 9 (4–18) 6 (3–11) 0.144 8 (4–18) 6 (3–10) 0.237 8 (12–19) 6 (2–20) 0.987
Central venous catheter 60 (16%) 35 (12%) 0.112 35 (15%) 25 (10%) 0.107 27 (10%) 15 (36%) 0.017
Central venous catheter days (median [IQR]) 11 (4–20) 8 (4–11) 0.164 12 (5–18) 7 (4–11) 0.076 11 (5–17) 6 (3–20) 0.894
Urinary catheter 143 (38%) 90 (32%) 0.052 82 (48%) 89 (37%) 0.283 85 (29%) 61 (18%) 0.004
Urinary catheter days (median [IQR]) 8 (5–16) 8 (5–11) 0.385 7 (5–16) 8 (5–11) 0.644 12 (8–18) 6 (3.5–19.5) 0.943
Mechanical ventilation 86 (23%) 42 (15%) 0.005 48 (20%) 36 (15%) 0.093 29 (10%) 16 (5%) 0.013
Mechanical ventilation days (median [IQR]) 9 (2.5–17) 0 (0–4) < 0.001 7 (2–17) 0 (0–4) 0.001 11 (5–15) 1 (0–5) 0.002
Infection site
 Bloodstream 65 (56%) 51 (18%) 0.455 44 (18%) 39 (16%) 0.315 39 (13%) 44 (13%) 0.522
 Urinary tract 213 (57%) 115 (41%) < 0.001 134 (56%) 97 (41%) < 0.001 197 (66%) 201 (60%) 0.053
 Respiratory tract 92 (24%) 44 (15%) 0.003 41 (17%) 50 (21%) 0.176 27 (9%) 32 (10%) 0.456
 Intraabdominal 16 (4%) 29 (10%) 0.002 12 (5%) 20 (8%) 0.100 17 (6%) 34 (10%) 0.025
 Skin/Soft tissue/Osteomyelitis 88 (23%) 76 (27%) 0.188 63 (26%) 71 (30%) 0.238 60 (20%) 41 (12%) 0.002
Positive culture ≥ 2 88 (23%) 32 (11%) < 0.001 59 (25%) 29 (12%) < 0.001 51 (17%) 257%) < 0.001
Polymicrobial 74 (20%) 19 (7%) < 0.001 54 (75%) 18 (8%) < 0.001 44 (15%) 20 (6%) < 0.001
APACHE score II (median [IQR]) 6 (1–16) 1 (1–12) 0.527 4 (1–19) 1 (1–12) 0.706  
Appropriate antibiotic therapy 203 (54%) 248 (88%) < 0.001 203 (85%) 203 (85%) 1.000 193 (64%) 287 (86%) < 0.001
In-hospital Mortality 81 (72%) 32 (28%) < 0.001 41 (61%) 26 (39%) 0.032 24 (65%) 13 (35%) 0.021
 Mortality due to infection 49 (77%) 15 (23%) 0.135 25 (64%) 14 (36%) 0.373 11 (58%) 8 (42%) 0.286
B-Economic parameters
LOS prior to index date (median [IQR]),days 0 (0–4) 0 (0–4) 0.426 0 (0–4) 0 (0–4) 0.520  
LOS post index date (median [IQR]),days 7 (4–14) 6 (3–10) 0.016 7 (5–14) 7 (4–11) 0.408 7 (4–12) 5 (3–8) < 0.001
Stay charges at ward levelb 761 (1094) 643 (797) 0.059 790 (1181) 661 (792) 0.200 534 (590) 364 (323) < 0.001
ICU stay chargesb 852 (2049) 508 (1252) 0.007 726 (1930) 466 (1158) 0.077 366 (1093) 240 (47) 0.109
Total stay chargesb 1122 (1532) 910 (1350) 0.063 1045 (1402) 894 (1260) 0.220 851 (1151) 578 (822) 0.001
Pharmaceuticals chargesb 1872 (3137) 1129 (1680) < 0.001 1851 (3458) 1030 (1505) 0.001 952 (1291) 628 (1191) 0.001
 Antibiotics chargesb 639 (1365) 314 (598) < 0.001 609 (1475) 269 (426) 0.001 378 (649) 193 (366) < 0.001
Medical Accessories chargesb 252 (1120) 163 (484) 0.243 231 (1176) 165 (461) 0.425 91 (288) 69 (450) 0.476
Oxygen chargesb 135 (658) 52 (151) 0.016 132 (760) 54 (151) 0.121 40 (168) 19 (73) 0.037
Imaging chargesb 310 (387) 292 (400) 0.224 318 (425) 277 (390) 0.280 252 (282) 185 (221) 0.001
Laboratory and microbiology chargesb 893 (1040) 756 (910) 0.018 868 (984) 714 (872) 0.071 638 (1080) 435 (413) 0.002
Third-party paymentb 3865 (4673) 2709 (3053) < 0.001 3740 (4826) 2567 (2701) 0.001 2829 (3183) 1930 (2186) < 0.001
Patient co-paymentb 379 (1684) 126 (764) < 0.001 513 (1066) 341 (582) 0.030 263 (1217) 104 (492) 0.001
Total charges from index dateb 4363 (5052) 2800 (3221) < 0.001 4278 (5027) 2882 (3108) < 0.001 329 (601) 199 (321) < 0.001
  1. Data are displayed as mean (standard deviation) or number (%) of patients unless indicated otherwise
  2. Percentages were rounded to the nearest whole number
  3. Index date: date of first positive culture
  4. a Within the preceding 90 days
  5. b Hospital charges from index date till discharge expressed as mean (SD), USD
  6. Community-associated infections were defined as those diagnosed within first 3 days of hospitalization in patients who had not been hospitalized in the previous 7 days. Healthcare-associated infections were defined as those diagnosed on third day in hospital or later
  7. Abbreviations: n, sample size; IQR, interquartile range; SD, standard deviation; ICU, Intensive care unit; CV, Central venous; APACHE II, Acute Physiology and Chronic Health Evaluation; LOS, Length of stay; USD, United States dollars