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C. difficile infection increased mortality, health care costs in patients with cirrhosis
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WASHINGTON, D.C. — Clostridium difficile infection led to increased mortality and health care resource utilization among patients with cirrhosis, according to data presented at ICAAC 2014.
“C. difficile is a substantial cause of morbidity, mortality, and increased costs in patients with cirrhosis,” Samuel L. Aitken, PharmD, BCPS, University of Houston College of Pharmacy, told Healio.com/Gastroenterology. “This is beyond what would be expected of non-cirrhotic patients with a similar level of comorbidity.”
Samuel L. Aitken
Aitken and colleagues compared incidence rates of C. difficile infection in the overall and cirrhotic populations using national database records from 2009. They evaluated CDI-related increases in length of hospital stay, in-hospital mortality and adjusted total cost.
Of the 7,802,351 hospital discharges analyzed, 1.46% patients had cirrhosis (mean age, 58.3 years; 61.2% men). CDI occurred in 189.5 per 10,000 discharges in cirrhotic patients compared with 85.3 per 10,000 overall (P<.01). Cirrhotic patients with CDI had greater in-hospital mortality compared with cirrhotic patients without CDI (OR=2.23; 95% CI, 1.98-2.52), and length of stay and total cost had average increases of 9.11 days (95% CI, 8.72-9.5) and $24,518 (95% CI, $23,256-$25,780), respectively. Cirrhotic patients with CDI exhibited a higher risk for in-hospital mortality compared with noncirrhotic controls with CDI matched for comorbidity (15.9% vs. 8.9%; P<.01), as well as higher total costs ($5,893; 95% CI, $5,853-$5,934). Lengths of stay were similar between groups.
“CDI is an important cause of the higher in-hospital mortality and health care resource utilization in patients with cirrhosis,” the researchers concluded. “Future research efforts should explore means to reduce the burden of CDI in the cirrhotic population.”
“As these patients are at higher risk for complications from C. difficile and traditional risk stratification measures may not adequately categorize patients with cirrhosis, clinicians should attempt to limit unnecessary antimicrobial use in this population whenever possible,” Aitken added.
For more information:
Aitken SL. Abstract K-361. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.
Disclosure: See the abstract for a full list of relevant financial disclosures.