The attributable clinical and economic burden of skin and skin structure infections in hospitalized patients: a matched cohort study

We estimated the incremental clinical and economic burden of skin and skin structure infections (SSSI) in hospitalized patients using a matched cohort study design. Cases with SSSI as secondary diagnosis were matched with up to 4 randomly selected non-SSSI controls by age, gender, admission date, and ICD-9 code of principal diagnosis. Among the 1 472 965 hospitalizations episodes, 23 026 had SSSI as their secondary diagnosis. Matching was successful in 22 551 (98%) cases. Compared with controls (n = 87 811), the cases had an average mean unadjusted length of hospital stay (LOS) of 5 days longer and excess hospital charges over $21 000 and higher mortality rate (5.4% versus 3.5%). Adjusted estimates from regression models revealed that SSSI incurred on average 3.81 additional days and $14 794 excess hospitalization charges. Risk of mortality was significantly higher in the cases (odds ratio, 1.32). P value was <0.0001 for all unadjusted and adjusted outcomes. Compared with their matched controls, patients with SSSI had significantly longer LOS, higher mortality, and higher hospital charges.