726 Jean Lee, PharmD Department of Pharmacy Sinai Hospital of Baltimore (410)245-2581 [email protected] Readmissions associated with Staphylococcus aureus bacteremia 1 Pharm.D. , 1,2 Pharm.D. , 1 Pharm.D. , 1 M.D. Jean E. Lee, Su Y. Lee, Colby Miller, John Cmar, 1 2 Sinai Hosp. of Baltimore, Baltimore, MD , Univ. Maryland Eastern Shore, Princess Anne, MD Abstract Methods Introduction: Staphylococcus aureus bacteremia (SAB) is one of the most common blood stream infections resulting in significant mortality and morbidity. The objective of the study was to evaluate outcomes in patients with SAB. Methods: We conducted a retrospective chart review of the patients who were admitted to the hospital in 2013, whose blood culture was positive of S. aureus. Outcomes evaluated were mortality, follow up blood cultures, length of stay (LOS), rate of readmission due to another SAB, and all-cause 30-and 60-day readmission rates. Statistical analyses were performed with SPSS software and Microsoft Excel software, with continuous and nominal data evaluated with the student t test and the Fisher’s exact test, respectively. Results: One hundred-three patients were identified to have 115 inpatient encounters associated with SAB. Mortality during index hospital stay was 17%. Among the survivors, 26% didn’t have confirmatory negative culture obtained prior to discharge. Length of stay (LOS) was significantly shorter in patients who didn’t have negative blood culture compared to patients who had negative culture (5.2 days vs. 14.9 days, P<0.0001). Eleven percent of patients had readmissions with another SAB during the study period. All-cause 30and 60-day readmission rates were 26% and 40%, respectively. In general, readmission rates were higher in MRSA bacteremia patients compared to MSSA bacteremia. Reviewing all-cause 60-day readmissions, 57% was due to an infection and 17 % was due to conditions related to index SAB, such as allergic reaction to antibiotic, acute kidney injury, intravascular line issues, and/or opportunistic infections. Overall, readmissions potentially associated with the index SAB accounted for 74% of all-cause 60 day readmissions. Conclusion: In patients who had index admission for SAB, readmission rate with another SAB was 11%. Allcause readmission rates were 26% and 40%, respectively in 30 days and 60 days. Seventy-four percent of 60 days readmissions were potentially related to the index SAB. We conducted a retrospective chart review of the patients who were admitted to the hospital in 2013, whose blood culture was positive of S. aureus. Outcomes evaluated were mortality, follow up blood cultures, length of stay (LOS), rate of readmission due to another SAB, and all-cause 30-and 60-day readmission rates. Statistical analyses were performed with SPSS software and Microsoft Excel software, with continuous and nominal data evaluated with the student t test and the Fisher’s exact test, respectively. Introduction Staphylococcus aureus (SA) bacteremia is one of the most common blood stream infections resulting in significant mortality and morbidity. The objective of the study was to evaluate outcomes in patients with SAB. Outcome data, including the readmission rate, has been reviewed to assess impact of SAB to hospital resource. Results SA Table 1. Overview of SAB audit SA, Survivors SAB # patients # SA cases Cases of MRSA Patients expired / hospice LOS, mean +/- Std dev Cases discharged without negative blood culture Days to negative blood culture, mean +/- Std dev LOS from + blood draw, mean +/- Std dev in cases without neg blood culture, mean +/- Std dev in cases with neg blood culture, mean+/- Std dev 103 115 70 17 13.3 (61%) (17%) +/- 11.8 87 98 58 (59%) 13.4 25 6.2 12.4 5.2 14.9 +/- 10.9 (26%) +/- 4.2 +/- 9.3 +/- 3.6 +/- 9.2 www.PosterPresentations.com MSSA 48 58 12.7 15 6.4 12.2 5.2 14.9 39 40 +/- 9.3 (26%) +/- 3.6 +/- 9.2 +/- 4.0 +/- 9.0 14.4 9 5.9 12.7 5.4 14.8 +/- 12.9 (23%) +/- 5.0 +/- 9.5 +/- 3.0 +/- 9.7 p=0.016 60% 50% 40% 30% 20% 10% 0% SA MRSA MSSA p=0.05 p=0.02 11% 52% 40% 35% 26% 19% 26% 15% 3% SAB readmission in 2013 All-cause 30-day Readmission All-cause 60-day Readmission Figure 1. SAB readmissions and All-cause readmissions Conclusion Due to an infection, 20 (57%) 60-day Readmission 40% No record of 60-day readmit 60% 74% potentially associated with index SAB Condition related to index SAB, 6 (17%) other, 9 (26%) Figure 2. Reasons for 60-day readmissions in SAB POSTER TEMPLATE BY: MRSA During 1-year cross-sectional period: • Readmission rate with another SAB was 11% – 19% vs. 3% for MRSA vs. MSSA, respectively • Thirty-day readmission rate was 26% – 35% vs. 15% for MRSA vs. MSSA • Sixty-day readmission rate was 40% – 52% vs. 26% for MRSA vs. MSSA – Seventy four percent of 60-day readmission were potentially associated with index SAB.
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