[Clostridium difficile infections in Spanish Internal Medicine departments during the period 2005-2010: the burden of the disease]

Abstract

Introduction: Clostridium Difficile infection (CDI) is increasing in Spain. A review is presented of this infection in order to evaluate the burden of the disease in this country.

Material: An analytical retrospective and descriptive study was conducted by analyzing the Minimum Basic Data Set of patients admitted to Internal Medicine Departments and with and without CDI between the years 2005-2010. Clinical and demographical variables were compared.

Results: Mean age was 75.5 years (SD 15.4), 54.9% were women and mean stay was 22.2 days (SD 24.8). The Cost [(€ 5,001 (SD 4,985) vs [€ 3,934 (SD 2,738)] and diagnostic complexity [2.04 (SD 2.62) vs [1.67 (SD 1.47)] were also different. Mortality for all causes was 12.5% vs 9.8%. Death risk showed a 30% increase (odds ratio 1.30, 95% confidence interval;1.21-1.39) and readmission rate was 30.4% vs 13.5%. Distribution of cases showed season variations (more cases in winter), and annual incidence increased during the study period. Comorbidities associated to increased risk of acquiring CDI were: anemia, human immunodeficiency virus, dementia, malnutrition, chronic renal failure, and living in a nursing home.

Conclusion: The results showed a clear negative impact of CDI on hospital admissions. A trend towards progression in its incidence without changes in mortality or readmission rates was observed, in common with the rest of Europe and the Western World.

Keywords: Burden of illness; Carga de la enfermedad; Clostridium difficile; Cost; Coste; Hospital mortality; Hospital readmission; Mortalidad hospitalaria; Reingresos hospitalarios; Seasonal variation; Variación estacional.