Cost analysis of a care package for the prevention of wound infections after craniotomy

Implementing a care package to prevent postoperative wound infections in patients undergoing a craniotomy (SSI-CRAN) has significantly reduced the health costs associated with the procedure, according to the results of a study published in Antimicrobial Resistance and Infection Control.

To assess the economic impact of the care package, researchers performed a retrospective cost analysis that compared the period before the introduction of the care package (2013-2015) to the period after the introduction of the care package (2016-2017). For both time periods and patient-to-patient, the researchers calculated the costs associated with craniotomy procedures between patients who developed SSIs compared to those who did not. The researchers analyzed the costs associated with the following factors: antibiotic treatment regimen, length of stay in the neurosurgical unit within a one-year follow-up period, re-intervention and implants for skull reconstruction.

Of the total of 1017 patients included in the analysis, 595 and 442 craniotomy operations were performed in the pre-care bundle or care bundle period. It is noteworthy that the incidence of SSI-CRAN was significantly reduced in the treatment bundle period compared to the pretreatment phase (3.5% vs. 15.3%; P <0.001).

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The average costs of a craniotomy and an SSI-CRAN were approximately € 8,000 (95% CI 7,350.6-8710.9) and € 24,000 (95% CI 21,180.6-27,316.4), respectively. After the introduction of the care package, the costs for patients who developed SSI-CRAN were reduced compared to the costs for patients who developed SSI-CRAN in the pre-treatment package period (€ 714,886 and € 212,029, respectively). Notably, the increased costs observed during the pre-care bundle phase are mainly due to longer hospital stays and surgical implants in patients in need of skull reconstruction.

After implementing the care package, researchers found that preventing SSI-CRAN saved the healthcare system a total of € 500,844.

This study was limited by the inclusion of only patients hospitalized in a single center. In addition, cost factors such as full parenteral nutrition, treatment in or readmission to another hospital, laboratory and imaging studies, and diagnostic tests were not included in the analysis.

According to the researchers, “Hospitals should be monitoring [SSIs] in the field of neurosurgery and should use strategies like that [care] bundle described here to [decrease] the burden of SSIs, both in terms of patient suffering and healthcare costs. “


Jiménez-Martínez E., Cuervo G, Carratalà J, et al. Economic Impact of a Package Care Package to Prevent Wound Infection After Craniotomy: A Cost Analysis Study.

Antimicrobial infection control. 2021; 10 (1): 146. doi: 10.1186 / s13756-021-01016-4.

This article originally appeared on Infectious Disease Advisor

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