In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study

Abstract Background It remains unclear whether methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with higher mortality compared with non-MRSA pneumonia. This study’s objective was to compare outcomes including in-hospital mortality and healthcare costs during hospitalisation...

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Autores principales:	Yukiyo Sakamoto, Yasuhiro Yamauchi, Taisuke Jo, Nobuaki Michihata, Wakae Hasegawa, Hideyuki Takeshima, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Takahide Nagase
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Methicillin-resistant Staphylococcus aureus pneumonia Community-acquired pneumonia In-hospital mortality Healthcare costs during hospitalisation Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/80b8cd48284b4bac89a0b019f067c47e
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spelling	oai:doaj.org-article:80b8cd48284b4bac89a0b019f067c47e2021-11-08T11:13:27ZIn-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study10.1186/s12890-021-01713-11471-2466https://doaj.org/article/80b8cd48284b4bac89a0b019f067c47e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12890-021-01713-1https://doaj.org/toc/1471-2466Abstract Background It remains unclear whether methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with higher mortality compared with non-MRSA pneumonia. This study’s objective was to compare outcomes including in-hospital mortality and healthcare costs during hospitalisation between patients with MRSA pneumonia and those with non-MRSA pneumonia. Methods Using a national inpatient database in Japan, we conducted a 1:4 matched-pair cohort study of inpatients with community-acquired pneumonia from 1 April 2012 to 31 March 2014. In-hospital outcomes (mortality, length of stay and healthcare costs during hospitalisation) were compared between patients with and without MRSA infection. We performed multiple imputation using chained equations followed by multivariable regression analyses fitted with generalised estimating equations to account for clustering within matched pairs. All-cause in-hospital mortality and healthcare costs during hospitalisation were compared for pneumonia patients with and without MRSA infection. Results Of 450,317 inpatients with community-acquired pneumonia, 3102 patients with MRSA pneumonia were matched with 12,320 patients with non-MRSA pneumonia. The MRSA pneumonia patients had higher mortality, longer hospital stays and higher costs. Multivariable logistic regression analysis revealed that MRSA pneumonia was significantly associated with higher in-hospital mortality compared with non-MRSA pneumonia (adjusted odds ratio = 1.94; 95% confidence interval: 1.72–2.18; p < 0.001). Healthcare costs during hospitalisation were significantly higher for patients with MRSA pneumonia than for those with non-MRSA pneumonia (difference = USD 8502; 95% confidence interval: USD 7959–9045; p < 0.001). Conclusions MRSA infection was associated with higher in-hospital mortality and higher healthcare costs during hospitalisation, suggesting that preventing MRSA pneumonia is essential.Yukiyo SakamotoYasuhiro YamauchiTaisuke JoNobuaki MichihataWakae HasegawaHideyuki TakeshimaHiroki MatsuiKiyohide FushimiHideo YasunagaTakahide NagaseBMCarticleMethicillin-resistant Staphylococcus aureus pneumoniaCommunity-acquired pneumoniaIn-hospital mortalityHealthcare costs during hospitalisationDiseases of the respiratory systemRC705-779ENBMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Methicillin-resistant Staphylococcus aureus pneumonia Community-acquired pneumonia In-hospital mortality Healthcare costs during hospitalisation Diseases of the respiratory system RC705-779
spellingShingle	Methicillin-resistant Staphylococcus aureus pneumonia Community-acquired pneumonia In-hospital mortality Healthcare costs during hospitalisation Diseases of the respiratory system RC705-779 Yukiyo Sakamoto Yasuhiro Yamauchi Taisuke Jo Nobuaki Michihata Wakae Hasegawa Hideyuki Takeshima Hiroki Matsui Kiyohide Fushimi Hideo Yasunaga Takahide Nagase In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
description	Abstract Background It remains unclear whether methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with higher mortality compared with non-MRSA pneumonia. This study’s objective was to compare outcomes including in-hospital mortality and healthcare costs during hospitalisation between patients with MRSA pneumonia and those with non-MRSA pneumonia. Methods Using a national inpatient database in Japan, we conducted a 1:4 matched-pair cohort study of inpatients with community-acquired pneumonia from 1 April 2012 to 31 March 2014. In-hospital outcomes (mortality, length of stay and healthcare costs during hospitalisation) were compared between patients with and without MRSA infection. We performed multiple imputation using chained equations followed by multivariable regression analyses fitted with generalised estimating equations to account for clustering within matched pairs. All-cause in-hospital mortality and healthcare costs during hospitalisation were compared for pneumonia patients with and without MRSA infection. Results Of 450,317 inpatients with community-acquired pneumonia, 3102 patients with MRSA pneumonia were matched with 12,320 patients with non-MRSA pneumonia. The MRSA pneumonia patients had higher mortality, longer hospital stays and higher costs. Multivariable logistic regression analysis revealed that MRSA pneumonia was significantly associated with higher in-hospital mortality compared with non-MRSA pneumonia (adjusted odds ratio = 1.94; 95% confidence interval: 1.72–2.18; p < 0.001). Healthcare costs during hospitalisation were significantly higher for patients with MRSA pneumonia than for those with non-MRSA pneumonia (difference = USD 8502; 95% confidence interval: USD 7959–9045; p < 0.001). Conclusions MRSA infection was associated with higher in-hospital mortality and higher healthcare costs during hospitalisation, suggesting that preventing MRSA pneumonia is essential.
format	article
author	Yukiyo Sakamoto Yasuhiro Yamauchi Taisuke Jo Nobuaki Michihata Wakae Hasegawa Hideyuki Takeshima Hiroki Matsui Kiyohide Fushimi Hideo Yasunaga Takahide Nagase
author_facet	Yukiyo Sakamoto Yasuhiro Yamauchi Taisuke Jo Nobuaki Michihata Wakae Hasegawa Hideyuki Takeshima Hiroki Matsui Kiyohide Fushimi Hideo Yasunaga Takahide Nagase
author_sort	Yukiyo Sakamoto
title	In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
title_short	In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
title_full	In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
title_fullStr	In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
title_full_unstemmed	In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
title_sort	in-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant staphylococcus aureus: a matched-pair cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/80b8cd48284b4bac89a0b019f067c47e
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In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study

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