Mean Duration (days) ± SD b. n = 587 n = 587

(1)

Online Table 1. Length of stay in matched cohorts of patients with VAP and patients without VAPa

MS-DRG Population (Code) Outcome Type

Mean Duration (days) ± SDb P With VAP Without VAP ECMO or tracheostomy with mechanical ventilation ≥96 hours or

principal diagnosis except face, mouth, and neck with major OR (3)

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 diagnosis except face, mouth, and neck without major OR (4)

n = 222 n = 222

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

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

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

comorbidity (853) n = 46 n = 46

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

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

comorbidity (329) n = 35 n = 35

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; VAP,

ventilator-associated pneumonia.

(2)

a

_{In general, there were few statistically significant differences between patients with and without}

VAP 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 VAP; 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 VAP 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 VAP were more likely to be males than patients without

VAP (59.0% vs 35.9%). In the population with MS-DRG 853: infection w/ OR and major

complication, the VAP 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 VAP

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).

(3)

Online Table 2. Costs in a matched cohort of patients with VAP and patients without VAP MS-DRG (Code)

Outcome Type

Mean Cost ($) ± SDa

P With VAP Without VAP

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 Pharmacy 21,318 ± 18,962 19,544 ± 27,124 .197 Antibiotic 2677 ± 5911 2442 ± 7138 .556 Vancomycin 425 ± 576 403 ± 537 .551

Propofol 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 Pharmacy 17,995 ± 19,811 12,669 ± 11,335 <.001 Antibiotic 2443 ± 3634 1700 ± 4273 .068 Vancomycin 393 ± 648 318 ± 409 .231

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

Pharmacy 6312 ± 5679 5500 ± 4607 .096

Antibiotic 1081 ± 1172 736 ± 1050 .002

Vancomycin 217 ± 280 203 ± 269 .663

Ventilator 3186 ± 3230 2450 ± 2883 .011

(4)

Outcome Type

Chest x-rays 954 ± 873 895 ± 647 .414

Septicemia or severe sepsis with mechanical ventilation ≥96 hours (870)

Nursing time 3275 ± 12,691 898 ± 2640 .100

Pharmacy 9523 ± 10,724 7468 ± 6671 .043

Antibiotic 1738 ± 2622 1025 ± 1023 .002

Vancomycin 251 ± 328 210 ± 278 .291

Ventilator 3236 ± 4169 2017 ± 1817 <.001

Chest x-rays 987 ± 798 792 ± 561 .013

Infectious and parasitic diseases with OR with major complication or comorbidity (853)

Nursing time 300 ± 454 3808 ± 9169 .104

Pharmacy 15,650 ± 17,692 10,399 ± 7642 .069

Antibiotic 2891 ± 4818 1703 ± 2046 .146

Vancomycin 332 ± 396 443 ± 835 .467

Ventilator 5176 ± 6789 1749 ± 1467 .001

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

Pharmacy 2747 ± 1914 2137 ± 1306 .107

Antibiotic 545 ± 590 238 ± 185 .006

Vancomycin 151 ± 199 95 ± 115 .405

Ventilator 1240 ± 1092 789 ± 551 .025

(5)

Outcome Type

Chest x-rays 579 ± 484 454 ± 263 .163

Major small and large bowel procedure with major complication or comorbidity (329)

Nursing time 4237 ± 14656 918 ± 2318 .323

Pharmacy 20,441 ± 47,013 12,976 ± 22,713 .401

Antibiotic 1794 ± 1898 1199 ± 1531 .163

Vancomycin 352 ± 535 174 ± 256 .196

Ventilator 2518 ± 1956 2258 ± 3418 .697

Chest x-rays 1414 ± 908 1143 ± 1264 .306