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Post-operative Pneumonia in the US
E146
American Journal of Infection Control June 2010
infections, and this association remained significant after controlling for other factors. There was also a multivariate association between SSI and BMI .5 30, diabetes, and surgeries not performed within the 75% cutoff time. Presentation Number: 184
Post-operative Pneumonia in the US Walter T. Linde-Zwirble, OHP, VP Research, ZD Associates LLC, Perkasie, PA; Jonathan D. Bloom, MD, Associate Director of Medical Affairs; Roger S. Mecca, MD, VP Medical Affairs; Douglas M. Hansell, MD, MPH, Chief Medical Officer & VP, Covidien, Boulder, CO Background: Post-operative pneumonia (PP) is known to be associated with adverse outcomes and added resource use. While this has been examined in a number of small single center studies and administrative databases using International Classification of Diseases codes (ICD-9-CM), there is no current national estimate of the burden of PP. Objectives: This study uses a current nationally project able database to estimate the burden of PP. Methods: We selected all surgical discharges from the Premier Hospital discharge database for 2008. We excluded those age ,18 and those with a principal diagnosis of infection. PP was identified by the presence of bacterial pneumonia ICD-9-CM codes (481, 482, 495 and 486) in any secondary coding space. We examined incidence, hospital and ICU length of stay (LOS), hospital mortality, and total cost. National projection for the year 2008 were made using Premier supplied projection weights. We calculated incremental resource use and outcomes by comparing cases without pulmonary complications to those with PP for each surgical condition and summarizing across all conditions. Results: There were 1,199,041 surgical discharges from 417 hospitals in the analysis cohort with a mortality rate of 1.2% (14,146 deaths). PP was present in 25,797 cases (2.2%), with a mortality rate of 11.1% (2,854) accounting for 20.2% of all operative deaths. The pneumonia rate varied greatly by surgery and among common surgeries was highest in respiratory surgeries (13.9%) and lowest in musculoskeletal surgeries (1.2%). projecting to national levels there were 167,200 PP cases in the US in 2008. PP cases were associated with 14,728 added deaths, 820,000 added non-ICU hospital days, 565,000 added ICU days and $ 3.525 Billion in added costs. Conclusions: PP is relatively uncommon in post-op patients, but is associated with a disproportionate share of hospital deaths. Better strategies for the prevention and management of post-operative pneumonia could lead to greatly improved outcomes and substantial savings. Presentation Number: 185
Detection of H1N1 on Hands and Household Surfaces of Infected Individuals Bevin Cohen, MPH, Columbia University School of Nursing, New York, NY; Dhritiman V. Mukherjee, PhD, Project Coordinator, Columbia University School of Nursing, New York, NY; Mary Ellen Bovino, RN, CEN, Manager, Urgent Care, Health Services at Columbia, Columbia University, New York, NY; Susan Whittier, PhD, D(ABMM), Associate Director, Clinical Microbiology Service, Columbia University Medical Center, New York, NY; Elaine L. Larson, RN, PhD, FAAN, CIC, Professor of Pharmaceutical and Therapeutic Research, Columbia University School of Nursing, New York, NY Background: Studies have demonstrated that influenza can live on artificially contaminated hands and surfaces, but viability on hands and surfaces from naturally infected people has not been characterized. Objectives: The purpose of this study was to determine the duration of viability of H1N1 on naturally contaminated hands and household surfaces. Methods: We recruited 20 students with lab-confirmed H1N1 infection between Sept-Dec 2009. A deep nasal and pharyngeal swab was taken from each participant to confirm H1N1 infection at the time of the study. Participants
American Journal of Infection Control June 2010
infections, and this association remained significant after controlling for other factors. There was also a multivariate association between SSI and BMI .5 30, diabetes, and surgeries not performed within the 75% cutoff time. Presentation Number: 184
Post-operative Pneumonia in the US Walter T. Linde-Zwirble, OHP, VP Research, ZD Associates LLC, Perkasie, PA; Jonathan D. Bloom, MD, Associate Director of Medical Affairs; Roger S. Mecca, MD, VP Medical Affairs; Douglas M. Hansell, MD, MPH, Chief Medical Officer & VP, Covidien, Boulder, CO Background: Post-operative pneumonia (PP) is known to be associated with adverse outcomes and added resource use. While this has been examined in a number of small single center studies and administrative databases using International Classification of Diseases codes (ICD-9-CM), there is no current national estimate of the burden of PP. Objectives: This study uses a current nationally project able database to estimate the burden of PP. Methods: We selected all surgical discharges from the Premier Hospital discharge database for 2008. We excluded those age ,18 and those with a principal diagnosis of infection. PP was identified by the presence of bacterial pneumonia ICD-9-CM codes (481, 482, 495 and 486) in any secondary coding space. We examined incidence, hospital and ICU length of stay (LOS), hospital mortality, and total cost. National projection for the year 2008 were made using Premier supplied projection weights. We calculated incremental resource use and outcomes by comparing cases without pulmonary complications to those with PP for each surgical condition and summarizing across all conditions. Results: There were 1,199,041 surgical discharges from 417 hospitals in the analysis cohort with a mortality rate of 1.2% (14,146 deaths). PP was present in 25,797 cases (2.2%), with a mortality rate of 11.1% (2,854) accounting for 20.2% of all operative deaths. The pneumonia rate varied greatly by surgery and among common surgeries was highest in respiratory surgeries (13.9%) and lowest in musculoskeletal surgeries (1.2%). projecting to national levels there were 167,200 PP cases in the US in 2008. PP cases were associated with 14,728 added deaths, 820,000 added non-ICU hospital days, 565,000 added ICU days and $ 3.525 Billion in added costs. Conclusions: PP is relatively uncommon in post-op patients, but is associated with a disproportionate share of hospital deaths. Better strategies for the prevention and management of post-operative pneumonia could lead to greatly improved outcomes and substantial savings. Presentation Number: 185
Detection of H1N1 on Hands and Household Surfaces of Infected Individuals Bevin Cohen, MPH, Columbia University School of Nursing, New York, NY; Dhritiman V. Mukherjee, PhD, Project Coordinator, Columbia University School of Nursing, New York, NY; Mary Ellen Bovino, RN, CEN, Manager, Urgent Care, Health Services at Columbia, Columbia University, New York, NY; Susan Whittier, PhD, D(ABMM), Associate Director, Clinical Microbiology Service, Columbia University Medical Center, New York, NY; Elaine L. Larson, RN, PhD, FAAN, CIC, Professor of Pharmaceutical and Therapeutic Research, Columbia University School of Nursing, New York, NY Background: Studies have demonstrated that influenza can live on artificially contaminated hands and surfaces, but viability on hands and surfaces from naturally infected people has not been characterized. Objectives: The purpose of this study was to determine the duration of viability of H1N1 on naturally contaminated hands and household surfaces. Methods: We recruited 20 students with lab-confirmed H1N1 infection between Sept-Dec 2009. A deep nasal and pharyngeal swab was taken from each participant to confirm H1N1 infection at the time of the study. Participants