Attributable Outcomes of Endemic Clostridium difficile–associated Disease in Nonsurgical Patients

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Dubberke, Erik R. ; Butler, Anne M. ; Reske, Kimberly A. ; Agniel, Denis ; Olsen, Margaret A. ; D’Angelo, Gina ; McDonald, L. Clifford ; Fraser, Victoria J.
• Description:
  Data are limited on the attributable outcomes of Clostridium difficile-associated disease (CDAD), particularly in CDAD-endemic settings. We conducted a retrospective cohort study of nonsurgical inpatients admitted for >/=48 hours in 2003 (N = 18,050). The adjusted hazard ratios for readmission (hazard ratio 2.19, 95% confidence interval [CI] 1.87-2.55) and deaths within 180 days (hazard ratio 1.23, 95% CI 1.03-1.46) were significantly different among CDAD case-patients and noncase patients. In a propensity score matched-pairs analysis that used a nested subset of the cohort (N = 706), attributable length of stay attributable to CDAD was 2.8 days, attributable readmission at 180 days was 19.3%, and attributable death at 180 days was 5.7%. CDAD patients were significantly more likely than controls to be discharged to a long-term-care facility or outside hospital. Even in a nonoutbreak setting, CDAD had a statistically significant negative impact on patient illness and death, and the impact of CDAD persisted beyond hospital discharge.
• Subjects:
  Aged Attributable Mortality Clostridium Difficile Clostridium Infections Cohort Studies Cross Infection Diarrhea Endemic Diseases Female Gastrointestinal Diseases Healthcare Epidemiology Hospital-associated Infections Hospitals, Teaching Humans Kaplan-Meier Estimate Length Of Stay Male Middle Aged Outcomes Patient Readmission Proportional Hazards Models Research Retrospective Studies

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• Source:
  Emerg Infect Dis. 14(7):1031-1038.
• Document Type:
  Journal Article
• Volume:
  14
• Issue:
  7
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:d8a5180025d6d479ccb90e41d8e2fd7b539eccd054e32710a18e8d80fd140ed7
• Download URL:
  https://stacks.cdc.gov/view/cdc/16938/cdc_16938_DS1.pdf
• File Type:
  [PDF - 161.60 KB ]