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Poorer outcomes, greater health care burden associated with recurrent vs. non-recurrent CDI
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WASHINGTON, D.C. — Recurrent Clostridium difficile infection is associated with inferior patient clinical outcomes and greater burden of resource utilization compared with non-recurrent infections, according to a cohort study presented at ICAAC 2014.
“Integrated health care delivery systems have the capability to analyze data from large cohorts,” Gabriel Escobar, MD, of the Kaiser Permanente Northern California Division of Research, told Healio.com/Gastroenterology, “and our analyses show the huge impact of Clostridium difficile, especially when it recurs.”
“Patients who have [C. difficile infection] (CDI) are at very high risk of having recurrences,” Yang Xie, PhD, MPH, of Merck & Co. told Healio.com/Gastroenterology. “Recurrences have a significant burden both in terms of the patient clinical outcomes and their economic outcomes.”
Yang Xie
Escobar, Xie and colleagues from Kaiser Permanente Northern California (KPNC) evaluated the burden of recurrent C. difficile infection by comparing clinical outcomes and utilization of healthcare resources of patients with a single episode of CDI (n=13,670) vs. recurrent infection (n=3,201) from September 2001 through 2010. Patients were matched based on age, gender, baseline comorbidity and KPNC membership year.
Mortality rate in the year after index was 20.2% for the recurrent CDI group compared with 15.3% of the non-recurrent CDI group. The recurrent CDI group had 1.7 emergency department visits per patient compared with 1.3 in the non-recurrent group; 9.7 days vs. 5.7 days of overnight hospitalization (recurrent CDI vs. non-recurrent CDI) and 1.1 vs. 0.6 ICU days (recurrent CDI vs. non-recurrent CDI).
“This study is a first attempt to assess the burden of CDI recurrence using a long term, large sample database, using matching algorithm to adjust for the confounding effect of patient baseline characteristics and comorbidities,” the researchers wrote. “After matching, we still observe significantly poorer patient clinical outcomes and higher healthcare resource utilization burden related to CDI recurrence vs. non-recurrent CDI. Identifying patients with higher risk for recurrence and preventing recurrences will be an important aspect of averting a serious complication of CDI.” –By Adam Leitenberger
For more information:
Escobar GJ. Abstract K-362. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.
Disclosure: Xie is an employee of Merck & Co. Escobar, Baker, Li and Kipnis report grant investigator or collaborative relationships with Merck & Co.