TY - JOUR
T1 - Attributable outcomes of endemic Clostridium difficile-associated disease in nonsurgical patients
AU - Dubberke, Erik R.
AU - Butler, Anne M.
AU - Reske, Kimberly A.
AU - Agniel, Denis
AU - Olsen, Margaret A.
AU - D'Angelo, Gina
AU - McDonald, L. Clifford
AU - Fraser, Victoria J.
PY - 2008/7
Y1 - 2008/7
N2 - Data are limited on the attributable outcomes of Clostridium difficile-associated disease (CDAD), particularly in CDAD-endemic settings. We conducted a retrospective cohort study of nonsurgical inpatients admitted for ≥48 hours in 2003 (N = 18,050). The adjusted hazard ratios for readmission (hazard ratio 2.19, 95% confidence interval [CI] 1.87-2.55) and deaths within 180 days (hazard ratio 1.23, 95% CI 1.03-1.46) were significantly different among CDAD case-patients and noncase patients. In a propensity score matched-pairs analysis that used a nested subset of the cohort (N = 706), attributable length of stay attributable to CDAD was 2.8 days, attributable readmission at 180 days was 19.3%, and attributable death at 180 days was 5.7%. CDAD patients were significantly more likely than controls to be discharged to a long-term-care facility or outside hospital. Even in a nonoutbreak setting, CDAD had a statistically significant negative impact on patient illness and death, and the impact of CDAD persisted beyond hospital discharge.
AB - Data are limited on the attributable outcomes of Clostridium difficile-associated disease (CDAD), particularly in CDAD-endemic settings. We conducted a retrospective cohort study of nonsurgical inpatients admitted for ≥48 hours in 2003 (N = 18,050). The adjusted hazard ratios for readmission (hazard ratio 2.19, 95% confidence interval [CI] 1.87-2.55) and deaths within 180 days (hazard ratio 1.23, 95% CI 1.03-1.46) were significantly different among CDAD case-patients and noncase patients. In a propensity score matched-pairs analysis that used a nested subset of the cohort (N = 706), attributable length of stay attributable to CDAD was 2.8 days, attributable readmission at 180 days was 19.3%, and attributable death at 180 days was 5.7%. CDAD patients were significantly more likely than controls to be discharged to a long-term-care facility or outside hospital. Even in a nonoutbreak setting, CDAD had a statistically significant negative impact on patient illness and death, and the impact of CDAD persisted beyond hospital discharge.
UR - http://www.scopus.com/inward/record.url?scp=46349087006&partnerID=8YFLogxK
U2 - 10.3201/eid1407.070867
DO - 10.3201/eid1407.070867
M3 - Article
C2 - 18598621
AN - SCOPUS:46349087006
SN - 1080-6040
VL - 14
SP - 1031
EP - 1038
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 7
ER -