Prolongation of length of stay and Clostridium difficile infection a review of the methods used to examine length of stay due to healthcare associated infections 英文参考文献.docVIP

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Prolongation of length of stay and Clostridium difficile infection a review of the methods used to examine length of stay due to healthcare associated infections 英文参考文献.doc

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Prolongation of length of stay and Clostridium difficile infection a review of the methods used to examine length of stay due to healthcare associated infections 英文参考文献

MitchellandGardnerAntimicrobialResistanceandInfectionControl2012,1:14 /content/1/1/14 RESEARCH OpenAccess ProlongationoflengthofstayandClostridium difficileinfection:areviewofthemethodsusedto examinelengthofstayduetohealthcare associatedinfections BrettGMitchell1*andAnneGardner1,2 Abstract Background:ItisbelievedthatClostridiumdifficileinfection(CDI)contributestoaprolongationoflengthofstay (LOS).RecentliteraturesuggeststhatmodelspreviouslyusedtodetermineLOSduetoinfectionhaveoverestimated LOS,comparedtonewerstatisticalmodels.ThepurposeofthisreviewistounderstandtheimpactthatCDIhason LOSandindoingso,describethemethodologicalapproachesused. Aim:First,toinvestigateanddescribethereportedprolongationofLOSinhospitalisedpatientswithCDI.Second, todescribethemethodologiesusedfordeterminingexcessLOS. Methods:Anintegrativereviewmethodwasused.Paperswerereviewedandanalysedindividuallyandthemes werecombinedusingintegrativemethods. Results:FindingsfromallstudiessuggestedthatCDIcontributestoalongerLOSinhospital.Instudiesthat comparedpersonswithandwithoutCDI,thedifferenceintheLOSbetweenthetwogroupsrangedfrom2.8days to16.1days.Potentiallimitationswithdataanalysiswereidentified,giventhatnostudyfullyaddressedtheissueof atime-dependentbiaswhenexaminingtheLOS.Recentliteraturesuggeststhatamulti-statemodelshouldbe usedtomanagetheissueoftime-dependentbias. Conclusion:StudiesexaminingLOSattributedtoCDIvariedconsiderablyindesignanddatacollected.Future studiesexaminingLOSrelatedtoCDIandotherhealthcareassociatedinfectionsshouldconsidercapturingthe timingofinfectioninordertobeabletoemployamulti-statemodelfordataanalysis. Keywords:Clostridiumdifficileinfection,Clostridiumdifficileassociateddiarrhoea,Cost,Healthcareassociated infection,Lengthofstay,Timedependentbias Background epidemic of a hypervirulent strain of C.difficile Clostridium difficile infection (CDI) is the leading cause (BI/NAP1)thathasbeenreportedintheUSAandother of infectious diarrhoea in hospitalised patients [1]. countries. I