Influence of preoperative anemia on postoperative nosocomial infection in heart valve replacement patients and economic burden

OBJECTIVE To analyze the effect of preoperative anemia on the nosocomial infection in patients undergoing heart valve replacement and its economic burden, to provide economic basis for the establishment of the clinical prevention and control measures. METHODS The demographic data, clinical and laboratory data of the 720 patients undergoing heart valve replacement of heart valve disease in a three-A tertiary hospital from Jan 1,2018 to Dec 31,2019 were collected. The risk factors for postoperative nosocomial infection of the patients with cardiac valve replacement were analyzed. RESULTS A total of 720 patients who met the criteria were included in the study. Postoperative nosocomial infection occurred in 151 cases, with an infection rate of 20.97%. Logistic regression analysis showed that age, preoperative anemia, indwelling gastric tube, ASA stage, left heart ejection fraction were independent risk factors for postoperative infection（P＜0.05）. Twenty-three pairs of groups were matched: hospitalization cost in the nosocomial infection group was 210 525.35 yuan, and that in the non-nosocomial infection group was 157 383.18 yuan; the total direct economic burden was 71 414.05 yuan（Z=-3.746, P＜0.001）, the difference between western medicine was the largest, the overall economic burden was 40 708.36 yuan（Z=-4.932,P＜0.001）. Hospital stay in the hospital infection group was 35 days, and that in the non-nosocomial infection group was 23 days, which indicated that the length of hospital stay of the patients extended by 12 days due to the nosocomial infections, leading to the indirect economic burden of 6 409.93 yuan to patients. CONCLUSION Preoperative anemia increases the risk of heart valve disease postoperative nosocomial infection, which leads to the increase of medical cost and the length of hospital stay. So in a proper condition, treating anemia can promote the benign outcome.