Healthcare associated infection – the impact on length of stay

S. Stewart, L. Haahr, C. Robertson, J. Pan, S. Kennedy, K. Kavanagh, J. Reilly

Research output: Contribution to conferenceAbstractpeer-review


Background: Increased length of stay for patients is an important measure of the
burden of HAI. This study estimated the excess length of stay attributable to HAI. Considering the impact on LOS of different HAI types is important in guiding investment in HAI prevention.
Methods: A one-year prospective incidence study of HAIs was performed in a teaching hospital and a general hospital in NHS Scotland in 2018/19. All adult inpatients with an overnight stay were included. HAI was
diagnosed using European Centre for Disease Prevention and Control case definitions. A multistate model was used to account for the time varying nature of HAI and the competing risks of death and discharge.
Results: The excess length of stay attributable to HAI was 7.8 days (95% CI 5.7-9.9). Median length of stay for HAI patients was 30 days and for non-HAI patients was 3 days. Using a simple comparison of duration of hospital stay for HAI cases and non-cases would overestimate the excess LOS
by 3.5 times (27 days compared with 7.8 days). The greatest impact on LOS was found for pneumonia 16.3 days (95%CI 7.5-25.2), blood stream infections 11.4 days (95%CI 5.8-17.0) and surgical site infection (SSI) 9.8 days (95%CI 4.5-15.0).
With an estimated total of 58,000 bed-days being occupied annually due to HAI, even a reduction of 10% in HAI incidence has the potential to free up 5,800 bed-days which could be used to treat an average of 1,706 elective patients in Scotland annually and help to reduce the number of patients awaiting planned treatment. This study should support decisions in infection prevention and control interventions locally,
nationally and internationally.
Original languageEnglish
Number of pages1
Publication statusPublished - 27 Nov 2020
EventEuropean Scientific Conference on Applied Infectious Disease Epidemiology 2020 - Online
Duration: 24 Nov 202027 Nov 2020 (Link to conference website)


ConferenceEuropean Scientific Conference on Applied Infectious Disease Epidemiology 2020
Abbreviated titleESCAIDE 2020
Internet address


  • healthcare associated infection
  • infection prevention and control
  • length of stay
  • multistate models


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