Health care consequences of hospitalization with Clostrioides difficile infection: a propensity score matching study

BMC Infect Dis. 2022 Jul 15;22(1):620. doi: 10.1186/s12879-022-07594-x.

Abstract

Background: Clostridiodies difficile infection (CDI) has been characterized by the Center for Disease Control and Prevention (CDC) as an urgent public health threat and a major concern in hospital, outpatient and extended-care facilities worldwide.

Methods: A retrospective cohort study of patients aged ≥ 18 hospitalized with CDI in New York State (NYS) between January 1, 2014-December 31, 2016. Data were extracted from NY Statewide Planning and Research Cooperative (SPARCS) and propensity score matching was performed to achieve comparability of the CDI (exposure) and non-CDI (non-exposure) groups. Of the 3,714,486 hospitalizations, 28,874 incidence CDI cases were successfully matched to 28,874 non-exposures.

Results: The matched pairs comparison demonstrated that CDI cases were more likely to be readmitted to the hospital at 30 (28.26% vs. 19.46%), 60 (37.65% vs. 26.02%), 90 (42.93% vs. 30.43) and 120 days (46.47% vs. 33.74), had greater mortality rates at 7 (3.68% vs. 2.0%) and 180 days (20.54% vs. 11.96%), with significant increases in length of stay and total hospital charges (p < .001, respectively).

Conclusions: CDI is associated with a large burden on patients and health care systems, significantly increasing hospital utilization, costs and mortality.

Keywords: Clostridioides difficile infection; Hospitalizations; Mortality; SPARCS.

MeSH terms

  • Clostridioides difficile*
  • Clostridium Infections*
  • Cross Infection*
  • Health Care Costs
  • Hospitalization
  • Humans
  • Length of Stay
  • Propensity Score
  • Retrospective Studies