This article is still only in a provisional state, and there isn't much in it to relate to nursing practice, but I thought it was fascinating as an example of the type of issue health care, hospital administration, and the nursing professional are going to be faced with in the near future.Researchers have discovered that patients with two T alleles at 9545 in the gene that codes for Interleukin 18 have higher levels of TNF-alpha and stay in the ICU longer after cardiac surgery.
Because of the whole diagnostic-related groups payment scheme, it would be interesting to know if hospitals are eating more costs for these patients' longer stays. If that turns out to be the case, can the situation be solved pharmacologically or will these patients be in danger of being rejected for cardiac surgeries?
I wonder if there will be genetic predispositions to the big nosocomial infections (foley-related UTI, ventilator-associated pneumonia, and central line blood infections) discovered as well? As these account for large health care costs, will insurance companies be forced to pay more for admitting these patients to ICU due to the increased risk the ICU takes on? Or will these people just be bumped from insurance, or what?
- David M Shaw, Ainsley M Sutherland, James A Russell, Samuel V Lichtenstein, Keith R Walley (2009). Novel polymorphism of interleukin-18 associated with greater inflammation after cardiac surgery Critical Care, 13 (1) DOI: 10.1186/cc7698
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