Raseen Tariq, MD1, Muhammad Waqas Tahir, MD2, Darrell Pardi, MD, MS1, Sahil Khanna, MBBS, MS1 1Mayo Clinic, Rochester, MN; 2Rochester General Hospital, Rochester, NY
Introduction: C difficile infection (CDI) is the most common nosocomial infection with high associated inpatient and outpatient costs and health care burden. We examined the trends and characteristics of CDI related hospitalizations from 2006 to 2018.
Methods: We used the National Inpatient Sample database from years 2006 through 2018, to identify patients admitted with primary or secondary diagnosis of CDI using the ICD-9 (008.45) or ICD-10 (A04.71 and A04.72) codes. We identified trends in nationwide estimates for annual admissions with CDI, age at admission, length of stay (LOS), in-patient mortality, Charlson comorbidity index (CCI) and total hospital charge (adjusted for inflation). We used Cochran-Armitage test for trend significance. Nationwide estimates were made using the weights provided in the database.
Results: Admissions for CDI increased from 310,840 in 2006 to a peak of 375,770 in 2011, followed by a decline to the lowest level of 298,930 in 2018. Median age of admission was 74 years in 2006, and it steadily declined to 66.26 years in 2018 (p-trend < 0.01). Average LOS also followed a similar trend of decline from 12.62 days in 2006 to 9.87 days in 2018 (p-trend < 0.01). Average LOS for those with primary diagnosis of CDI declined from 7.04 to 5.36 days (p-trend < 0.01) over the same period. Although the Charlson Comorbidity Index increased during this period from 1.59 (Standard Error (SE) 0.005) to 2.09 (SE 0.006) (p-trend < 0.01), the in-patient mortality significantly decreased from 9.2% to 6.0% (p-trend < 0.01). Total charges for hospitalization (after adjusting for inflation) increased from $28,203 to $50,194 (p-trend < 0.01) for primary and from $74,079 to $161,161 for secondary diagnosis of CDI (Figure).
Discussion: The number of CDI related hospitalizations have declined from 2011 with an increase in the cost of care, which may be related to a corresponding increase in comorbidities. LOS and inpatient mortality has steadily declined since 2006 suggesting better management of CDI related hospitalizations.
Figure: Nationwide trends of costs associated with CDI related hospitalization
Raseen Tariq indicated no relevant financial relationships.
Muhammad Waqas Tahir indicated no relevant financial relationships.
Darrell Pardi: Vedanta – Consultant.
Sahil Khanna indicated no relevant financial relationships.
Raseen Tariq, MD1, Muhammad Waqas Tahir, MD2, Darrell Pardi, MD, MS1, Sahil Khanna, MBBS, MS1. P0122 - Trends in Admissions, Outcomes and Financial Burden of C. difficile Infection-Related Hospitalizations: A Nationwide Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.