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• W2914360388 abstract "Introduction: Over the past decade, the rates and mortality of Clostridium difficile infection (CDI) and were reported to have increased. This period saw significant epidemiological changes such as emergence of more virulent strains, development of improved diagnostic methods and therapies. Though some studies have evaluated the burden of CDI at a national level, these are now relatively old and display limited number of outcomes. Therefore, the aim of this study was to explore the recent incidence, morbidity, mortality, and resource utilization of patients with CDI in the past decade using a national database. Methods: Retrospective cohort study using the National Inpatient Sample from 2004 to 2013, the largest publically available inpatient database in the US. All patients with an ICD-9CM code for a principal diagnosis code of CDI were included in the study. There were no exclusion criteria. The primary outcome was inpatient mortality. Secondary outcomes were inpatient morbidity, measured by colectomy rates; resource utilization, measured by colonoscopy rates and length of hospital stay (LOS), and total hospitalization charges (adjusted for inflation). Odds ratios and means were adjusted for confounders using multivariate logistic regression. Results: 3,325,872 patients with CDI were identified, of which 1,021,454 met the inclusion criteria. Mean age was 68 years and 65% were female. Total cases increased from 60,137 in 2004 to 111,285 in 2013. Although the mortality rate peaked at 4.1% in 2005, it decreased 44% during the past decade, from 3.6% to 2%. A total 16,313 (1.6%) underwent colonoscopy in the study period, and 4,440 patients (0.4%) underwent Colectomy. The use of colonoscopy, colectomy rates, LOS and hospital charges decreased, while total hospitalization charges did not differ after adjusting for confounders. Table 1 shows all adjusted odds ratios, means and variable magnitude change.Table: Table. Crude and adjusted values for Mortality, Length of Stay, Total Hospitalization Charges, Hospital Costs, Colectomy and Colonoscopy use in patients who were admitted for Clostridium difficile infection in 2013 compared to 2004.Figure: Mortality trend during the past decade for patients admitted to the hospital with Clostridium difficile infection (95%CI: 0.91-0.93, p<0.01).Conclusion: Despite having peaked in the latter half of the past decade, Clostridium difficile infection mortality rates decreased in the past 5 years in the US. This may reflect the impact of improved detection methods, novel therapies and increased situational awareness. Similarly, colectomy use in patients with CDI decreased. For resource utilization, hospital costs, colonoscopy and hospital length of stay also decreased in the past decade. However, total hospitalization charges did not vary, in part reflecting changing insurance policies and models." @default.
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• W2914360388 date "2017-10-01" @default.
• W2914360388 modified "2023-10-11" @default.
• W2914360388 title "The In-hospital Mortality Rate for Clostridium difficile Infection has Decreased Over the Past Decade in the United States: A 10-Year Nationwide Analysis" @default.
• W2914360388 doi "https://doi.org/10.14309/00000434-201710001-01107" @default.
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