OBJECTIVES: Our aim was to characterize the temporal changes in burden that Clostridium difficile infection (CDI) added to the hospital care of children and young adults with inflammatory bowel disease (IBD) in the United States. METHODS: Retrospective analysis of annual, nationally representative samples of children and young adults with IBD. RESULTS: There was a 5-fold increase in IBD hospitalizations with CDI from 1997 to 2011 (P for trend <0.01). During the same period, IBD hospitalizations without CDI increased 2-fold (P for trend <0.01). Mean length of stay for IBD hospitalizations with CDI was consistently longer than that for hospitalizations without CDI and did not significantly change over time (P for trend = 0.47). CDI-related total hospital days in the United States rose from 1702 to 10,194 days per million individuals per year from 1997 to 2011 (P for trend <0.01). Children and young adults hospitalized with CDI had a significantly lower odds of colectomy (0.31) compared with those without CDI. Total charges for CDI-related hospitalizations among children and young adults in the United States rose from $8.7 million in 1997 to $68.2 million in 2011. CONCLUSIONS: A widening gap in burden has opened between IBD hospitalizations with and without CDI during the last decade and a half. CDI-related hospitalizations are associated with disproportionately longer lengths of stay, more hospital days, and more charges than hospitalizations without CDI over time. Further work within health systems, hospitals, and practices can help us better understand this enlarging gap to improve clinical care for this vulnerable population.
OBJECTIVES: Our aim was to characterize the temporal changes in burden that Clostridium difficileinfection (CDI) added to the hospital care of children and young adults with inflammatory bowel disease (IBD) in the United States. METHODS: Retrospective analysis of annual, nationally representative samples of children and young adults with IBD. RESULTS: There was a 5-fold increase in IBD hospitalizations with CDI from 1997 to 2011 (P for trend <0.01). During the same period, IBD hospitalizations without CDI increased 2-fold (P for trend <0.01). Mean length of stay for IBD hospitalizations with CDI was consistently longer than that for hospitalizations without CDI and did not significantly change over time (P for trend = 0.47). CDI-related total hospital days in the United States rose from 1702 to 10,194 days per million individuals per year from 1997 to 2011 (P for trend <0.01). Children and young adults hospitalized with CDI had a significantly lower odds of colectomy (0.31) compared with those without CDI. Total charges for CDI-related hospitalizations among children and young adults in the United States rose from $8.7 million in 1997 to $68.2 million in 2011. CONCLUSIONS: A widening gap in burden has opened between IBD hospitalizations with and without CDI during the last decade and a half. CDI-related hospitalizations are associated with disproportionately longer lengths of stay, more hospital days, and more charges than hospitalizations without CDI over time. Further work within health systems, hospitals, and practices can help us better understand this enlarging gap to improve clinical care for this vulnerable population.
Authors: Chaitanya Pant; Michael P Anderson; Abhishek Deshpande; John E Grunow; Judith A O'Connor; Jessica R Philpott; Thomas J Sferra Journal: J Investig Med Date: 2013-08 Impact factor: 2.895
Authors: Yogesh M Shastri; Dominik Bergis; Nada Povse; Volker Schäfer; Sarika Shastri; Martin Weindel; Hans Ackermann; Jürgen Stein Journal: Am J Med Date: 2008-12 Impact factor: 4.965
Authors: Grace O Androga; Julie Hart; Niki F Foster; Adrian Charles; David Forbes; Thomas V Riley Journal: J Clin Microbiol Date: 2015-09-09 Impact factor: 5.948
Authors: Frederic D Bushman; Maire Conrad; Yue Ren; Chunyu Zhao; Christopher Gu; Christopher Petucci; Min-Soo Kim; Arwa Abbas; Kevin J Downes; Nina Devas; Lisa M Mattei; Jessica Breton; Judith Kelsen; Sarah Marakos; Alissa Galgano; Kelly Kachelries; Jessi Erlichman; Jessica L Hart; Michael Moraskie; Dorothy Kim; Huanjia Zhang; Casey E Hofstaedter; Gary D Wu; James D Lewis; Joseph P Zackular; Hongzhe Li; Kyle Bittinger; Robert Baldassano Journal: Cell Host Microbe Date: 2020-08-20 Impact factor: 31.316