Cost-of-Illness Analysis of Candidemia in Patients on the Intensive Care Unit

Ref ID: 18781

Author:

S. Heimann, Masters (MA or MS) – Scientist, O. Cornely, Professor of Medicine – Scientist, H. Wisplinghoff, MD – Scientist, M. Vehreschild, MD – Scientist, B. Franke, data manager – Scientist, J. Glossmann, MD – Scientist, J. Vehreschild, MD – Scient

Author address:

Univ. Hosp. of Cologne, Köln, Germany.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Direct and indirect costs (cts) caused by candidemia in ICU patients (pts) are currently unknown. Method: Data of pts with at least one blood culture positive (bcp) for Candida spp. while staying on the ICU between 2005-10 were documented. Indirect cts were calculated using the friction cost method. Analysis was split for pts treated with new antifungals (NA), (i.e. echinocandins, lip. amp. B, or voriconazole) or conventional antifungals (CA), (i.e. amp. B deoxycholate or fluconazole). Result: Out of 147 pts, 45 received NA and 66 CA, and 36 pts were excluded from analysis (21 died within 96 hrs after bcp, 7 were rated as contamination, 8 patient files were missing). Mean APACHE IV was 113 (105.7-121.2) vs. 96 (90.3-100.8, P=<0,001). Mean direct cts per patient in the NA & the CA groups were: ICU treatment 24,922 € (95% CI: 17,054-31,789 €) vs. 17,971 € (95% CI: 13,203-22,740 €,P=n.s.), antifungal treatment 4,271 € (95% CI: 2,983-5,560 €) vs. 2,079 € (95% CI: 1,246-2,912 €, P=0.005), total direct cts 41,060 € (95% CI: 30,184-51,935 €) vs. 28,885 € (95% CI: 22,116-35,654 €, n.s.), indirect cts per patient due to productivity loss of illness-related disability 1,202 € (95% CI: 474-1,930 €) vs. 1,087 € (95% CI: 570-1,604 €, n.s.), due to death before retirement age 1,047 € (95% CI: 236-1,858 €) vs. 1,309 € (95% CI: 584-2,034 €, n.s.). Twenty-five (56%) and 33 (50%) pts survived hospitalization, 20 (44%) and 22 (33%) pts survived one year after diagnosis. Conclusion: Our analysis shows the high treatment cts of pts with candidemia. The treatment with NA was associated with higher cts. Although sicker pts were significant more likely to receive NA, outcomes were comparable to less sick pts treated with CA.

Abstract Number: M-1230

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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