Excess Mortality, Hospital Stay, and Cost Due to Candidemia: A Case-Control Study Using Data From Population-Based Candidemia Surveillance

Infect Control Hosp Epidemiol. 2005 Jun;26(6):540-7. doi: 10.1086/502581.


Objective: To determine the mortality, hospital stay, and total hospital charges and cost of hospitalization attributable to candidemia by comparing patients with candidemia with control-patients who have otherwise similar illnesses. Prior studies lack broad patient and hospital representation or cost-related information that accurately reflects current medical practices.

Design: Our case-control study included case-patients with candidemia and their cost-related data, ascertained from laboratory-based candidemia surveillance conducted among all residents of Connecticut and Baltimore and Baltimore County, Maryland, during 1998 to 2000. Control-patients were matched on age, hospital type, admission year, discharge diagnoses, and duration of hospitalization prior to candidemia onset.

Results: We identified 214 and 529 sets of matched case-patients and control-patients from the two locations, respectively. Mortality attributable to candidemia ranged between 19% and 24%. On multivariable analysis, candidemia was associated with mortality (OR, 5.3 for Connecticut and 8.5 for Baltimore and Baltimore County; P < .05), whereas receiving adequate treatment was protective (OR, 0.5 and 0.4 for the two locations, respectively; P < .05). Candidemia itself did not increase the total hospital charges and cost of hospitalization; when treatment status was accounted for, having received adequate treatment for candidemia significantly increased the total hospital charges and cost of hospitalization ($6,000 to $29,000 and $3,000 to $22,000, respectively) and the length of stay (3 to 13 days).

Conclusion: Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Baltimore / epidemiology
  • Candidiasis* / economics
  • Candidiasis* / mortality
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Connecticut / epidemiology
  • Cost of Illness
  • Cross Infection* / economics
  • Cross Infection* / mortality
  • Female
  • Fungemia* / economics
  • Fungemia* / mortality
  • Hospital Charges / statistics & numerical data*
  • Hospital Costs / statistics & numerical data*
  • Hospital Mortality*
  • Humans
  • Infant
  • Length of Stay / economics*
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Population Surveillance