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C. difficile led to extended hospital stay

Issue: January 2012

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A hospital-acquired infection with Clostridium difficile significantly increased the length of hospital stay.

“We believe our study provides the most accurate measure yet of the impact of hospital-acquired C. difficile on length of hospital stay,” Alan J. Forster, MD, MSc, of the Ottawa Hospital Research Institute, said in a press release. “Tools such as the Ottawa Hospital Data Warehouse are providing us with more accurate information about C. difficile infection than we’ve ever had before, and this is helping us improve our infection prevention efforts and also analyze their cost-effectiveness.”

For the retrospective, observational cohort study, Forster and colleagues pooled data on admissions to the Ottawa Hospital between July 1, 2002, and March 31, 2009. Associations between acquisition of C. difficile infection and the time to hospital discharge were assessed.

Of 136,877 hospital admissions, 1,393 cases of hospital-acquired infections with C. difficile were identified; overall risk was 1.02% (95% CI, 0.97-1.06).

The researchers found that patients who became infected with C. difficile stayed a median length of 34 days in the hospital vs. 8 days for patients without C. difficile.

Further, patients with C. difficile had a higher number of chronic diseases and a higher baseline risk for death than those without C. difficile (8% vs. 1.8%), which increased the median length of stay by 6 days, according to the study.

In an accompanying editorial, David A. Enoch, MRCP, FRCPath, and Sani H. Aliyu, MRCP, FRCPath, both of Addenbrooke’s Hospital in Cambridge, United Kingdom, wrote: “Adhering to basic evidence-based precautions can rapidly reduce the transmission of C. difficile and its associated mortality. Surveillance is essential to assess the efficacy of interventions. Such measures appear to have reduced the rates of infection in the U.K., possibly because of increased management and clinical responsibility.”

For more information:

• Enoch DA. CMAJ. 2011;doi:10.1503/cmaj.111449.
• Forster AJ. CMAJ. 2011;doi:10.1503/cmaj.110543.

Disclosure: Dr. Forster received peer-reviewed grant funding from the Canadian Patient Safety Institute.

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