Excess length of stay attributable to nosocomial bacteremia: usefulness ofthe Appropriateness Evaluation Protocol

BACKGROUND: To evaluate the usefulness of the Appropriateness Evaluation Pr otocol (AEP) for assessing the extra length of stay attributable to nosocom ial bacteremia. PATIENTS AND METHODS: Retrospective review of the medical records (1989, 19 90 and 1991) of all patients, who developed Staphylococcus aureus nosocomia l bacteremia. Evaluation of hospital stay was performed using the AEP. Calc ulation of the kappa index and intraclass correlation coefficient. RESULTS: A total of 158 patients were included S. aureus nosocomial bactere mia is responsible for a mean excess length of stay of 4.3 days per patient . Kappa index for the method used was 76%, and intraclass correlation coeff icient was 61%. CONCLUSIONS: The AEP has been shown to be a reliable toot for assessing the extra days of stay attributable to nosocomial bacteremia in the Spanish Na tional Health System. The use of AEP should be extended to assess the extra stay attributable to other types of nosocomial infections.