Online Table 1. Length of stay in matched cohorts of patients with VA and patients without VA a MS-DRG opulation (Code) ECMO or tracheostomy with mechanical ventilation 96 hours or principal diagnosis except face, mouth, and neck with major OR (3) Mean Duration (days) ± SD b With VA Without VA n = 587 n = 587 Mechanical ventilation 30.6 ± 27.3 25.5 ± 20.2 <.001 ICU 29.7 ± 18.2 27.9 ± 20.9.115 Hospital 46.0 ± 33.5 44.1 ± 42.2.399 Tracheostomy with mechanical ventilation 96 hours or principal n = 222 n = 222 diagnosis except face, mouth, and neck without major OR (4) Mechanical ventilation 30.8 ± 26.0 22.2 ± 12.6 <.001 ICU 26.2 ± 15.8 21.8 ± 11.6 <.001 Hospital 42.1 ± 41.7 30.5 ± 16.7 <.001 Respiratory system diagnosis with ventilator support 96 hours (207) n = 226 n = 226 Mechanical ventilation 14.2 ± 11.0 10.5 ± 9.5 <.001 ICU 12.7 ± 11.5 10.2 ± 5.5.004 Hospital 18.6 ± 19.6 16.0 ± 10.8.083 Septicemia or severe sepsis with mechanical ventilation 96 hours (870) n = 157 n = 157 Mechanical ventilation 17.4 ± 17.8 9.4 ± 4.5 <.001 ICU 15.0 ± 12.1 11.0 ± 5.6 <.001 Hospital 22.6 ± 25.6 16.0 ± 9.3.003 Infectious and parasitic diseases with OR with major complication or n = 46 n = 46 comorbidity (853) Mechanical ventilation 30.0 ± 48.7 8.8 ± 5.6.004 ICU 17.6 ± 16.8 12.3 ± 7.6.053 Hospital 36.9 ± 48.0 32.1 ± 53.6.650 Respiratory system diagnosis with ventilator support <96 hours (208) n = 39 n = 39 Mechanical ventilation 5.6 ± 5.3 3.7 ± 1.1.032 ICU 4.8 ± 3.0 3.5 ± 1.9.024 Hospital 9.3 ± 8.3 7.7 ± 4.8.321 Major small and large bowel procedure with major complication or n = 35 n = 35 comorbidity (329) Mechanical ventilation 11.7 ± 6.8 9.0 ± 11.2.224 ICU 16.9 ± 9.4 13.2 ± 11.9.155 Hospital 25.9 ± 12.6 22.3 ± 16.4.315 ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; MS-DRG, Medicare Severity diagnosis-related group; OR, operating room procedure; SD, standard deviation; VA, ventilator-associated pneumonia. age 1 of 5
a In general, there were few statistically significant differences between patients with and without VA in the seven MS-DRG categories. Specifically, there were no differences in patient or hospital characteristics for the populations with MS-DRG 3: trach w/ MV 96 h with major OR, MS-DRG 4: trach w/ MV 96 h without major OR, MS-DRG 870: sepsis w/ MV 96 h, and MS-DRG 329: bowel procedure with major complication. The population with MS-DRG 207: respiratory diagnosis w/ MV 96 h had higher rates of transfer to rehabilitation or skilled nursing facilities than patients without VA; they had lower rates of being discharged to home or mortality. The population with MS-DRG 208: respiratory diagnosis w/ MV <96 h was generally analogous except that patients with VA had higher admission rates from other health facilities and lower admission rates through the emergency room or physician referrals as well as lower transfer rates to another hospital. Also in the population with MS-DRG 208: respiratory diagnosis w/ MV <96 h, patients with VA were more likely to be males than patients without VA (59.0% vs 35.9%). In the population with MS-DRG 853: infection w/ OR and major complication, the VA population had a higher mortality rate (41.3% vs 15.2%) and lower rates of discharge to home, hospice, skilled nursing facility, or rehabilitation facility. The VA population was more heavily concentrated in the northeast (23.9% vs 4.4%) and less concentrated in the south (26.1% vs 52.2%; data not shown). b Unless otherwise stated. age 2 of 5
Online Table 2. Costs in a matched cohort of patients with VA and patients without VA With VA Without VA ECMO or tracheostomy with mechanical ventilation 96 hours or principal diagnosis except face, mouth, and neck with major OR (3) Hospitalization 153,625 ± 105,696 142,827 ± 125,400.113 Nursing time 5125 ± 25,149 7463 ± 23,720.262 harmacy 21,318 ± 18,962 19,544 ± 27,124.197 Antibiotic 2677 ± 5911 2442 ± 7138.556 Vancomycin 425 ± 576 403 ± 537.551 ropofol for sedation 953 ± 1699 806 ± 1558.161 Ventilator 6653 ± 7535 5789 ± 6055.032 Ventilator in ICU 5413 ± 5098 4900 ± 5029.086 Respiratory therapy 3606 ± 5124 3292 ± 7653.428 Chest x-rays 2620 ± 1858 2342 ± 1968.013 Tracheostomy with mechanical ventilation 96 hours or principal diagnosis except face, mouth, and neck without major OR (4) Hospitalization 112,865 ± 77,784 83,187 ± 44,590 <.001 Nursing time 3296 ± 15,627 6285 ± 18,615.201 harmacy 17,995 ± 19,811 12,669 ± 11,335 <.001 Antibiotic 2443 ± 3634 1700 ± 4273.068 Vancomycin 393 ± 648 318 ± 409.231 ropofol for sedation 1177 ± 1799 867 ± 1205.071 Ventilator 6813 ± 7808 4322 ± 3293 <.001 Ventilator in ICU 5269 ± 6540 3576 ± 2753 <.001 Respiratory therapy 3619 ± 3885 2373 ± 2359 <.001 Chest x-rays 2274 ± 1648 1624 ± 1150 <.001 Respiratory system diagnosis with ventilator support 96 hours (207) Hospitalization 46,928 ± 34,145 41,627 ± 24,701.060 Nursing time 2211 ± 8474 1333 ± 5446.339 harmacy 6312 ± 5679 5500 ± 4607.096 Antibiotic 1081 ± 1172 736 ± 1050.002 Vancomycin 217 ± 280 203 ± 269.663 ropofol for sedation 980 ± 1630 650 ± 974.051 Ventilator 3186 ± 3230 2450 ± 2883.011 Ventilator in ICU 2465 ± 2543 2068 ± 1784.058 age 3 of 5
Online Table 2. Costs in a matched cohort of patients with VA and patients without VA With VA Without VA Respiratory therapy 1583 ± 1726 1393 ± 1209.194 Chest x-rays 954 ± 873 895 ± 647.414 Septicemia or severe sepsis with mechanical ventilation 96 hours (870) Hospitalization 59,238 ± 58,111 44,642 ± 25,851.005 Nursing time 3275 ± 12,691 898 ± 2640.100 harmacy 9523 ± 10,724 7468 ± 6671.043 Antibiotic 1738 ± 2622 1025 ± 1023.002 Vancomycin 251 ± 328 210 ± 278.291 ropofol for sedation 819 ± 1868 544 ± 638.209 Ventilator 3236 ± 4169 2017 ± 1817 <.001 Ventilator in ICU 2351 ± 2592 1862 ± 1728.052 Respiratory therapy 2107 ± 3366 1251 ± 1385.005 Chest x-rays 987 ± 798 792 ± 561.013 Infectious and parasitic diseases with OR with major complication or comorbidity (853) Hospitalization 103,082 ± 91,291 66,972 ± 51,444.022 Nursing time 300 ± 454 3808 ± 9169.104 harmacy 15,650 ± 17,692 10,399 ± 7642.069 Antibiotic 2891 ± 4818 1703 ± 2046.146 Vancomycin 332 ± 396 443 ± 835.467 ropofol for sedation 1177 ± 3406 382 ± 547.198 Ventilator 5176 ± 6789 1749 ± 1467.001 Ventilator in ICU 2783 ± 2673 1503 ± 1074.004 Respiratory therapy 3693 ± 4875 1272 ± 1651.003 Chest x-rays 1713 ± 2055 956 ± 623.019 Respiratory system diagnosis with ventilator support <96 hours (208) Hospitalization 25,612 ± 20,324 17,593 ± 8269.027 Nursing time 215 ± 417 708 ± 1859.341 harmacy 2747 ± 1914 2137 ± 1306.107 Antibiotic 545 ± 590 238 ± 185.006 Vancomycin 151 ± 199 95 ± 115.405 ropofol for sedation 237 ± 295 219 ± 264.842 Ventilator 1240 ± 1092 789 ± 551.025 Ventilator in ICU 905 ± 704 670 ± 471.089 age 4 of 5
Online Table 2. Costs in a matched cohort of patients with VA and patients without VA With VA Without VA Respiratory therapy 824 ± 1333 569 ± 477.290 Chest x-rays 579 ± 484 454 ± 263.163 Major small and large bowel procedure with major complication or comorbidity (329) Hospitalization 90,799 ± 62,532 69,767 ± 77,229.215 Nursing time 4237 ± 14656 918 ± 2318.323 harmacy 20,441 ± 47,013 12,976 ± 22,713.401 Antibiotic 1794 ± 1898 1199 ± 1531.163 Vancomycin 352 ± 535 174 ± 256.196 ropofol for sedation 708 ± 925 413 ± 713.210 Ventilator 2518 ± 1956 2258 ± 3418.697 Ventilator in ICU 2457 ± 1961 2146 ± 3333.635 Respiratory therapy 2038 ± 1575 1312 ± 1333.057 Chest x-rays 1414 ± 908 1143 ± 1264.306 ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; MS-DRG, Medicare Severity diagnosis-related group; OR, operating room procedure; SD, standard deviation; VA, ventilator-associated pneumonia. age 5 of 5