Yingxi Chen1, Kathryn Glass1, Bette Liu2, Rosemary J Korda1, Thomas V Riley3, Martyn D Kirk4. 1. Research School of Population Health, Australian National University, Canberra, Australia. 2. School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. 3. Microbiology and Immunology, University of Western Australia, Nedlands, Australia; Department of Microbiology Path West Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Australia. 4. Research School of Population Health, Australian National University, Canberra, Australia. Electronic address: martyn.kirk@anu.edu.au.
Abstract
BACKGROUND: Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians. METHODS: We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations. We then compared hospitalizations with CDI as a secondary diagnosis to non-CDI hospitalizations by stratifying hospitalizations based on principal diagnosis and then using generalized linear models to compare LOS and in-hospital costs, and logistic regression for in-hospital deaths, adjusting for age and sex. RESULTS: There were 641 CDI hospitalizations during 2006-2012. The average LOS was 17 days; the average cost per hospitalization was AUD 12,704; and in 7.3% of admissions (47 out of 641) the patient died. After adjusting for age and sex, hospitalizations with CDI were associated with longer LOS, higher costs, and a greater proportion of in-hospital deaths compared with hospitalizations with similar principal diagnosis but without CDI. CONCLUSIONS: CDI places additional burden on the Australian hospital system, with CDI patients having relatively lengthy hospital stays and high costs.
BACKGROUND:Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians. METHODS: We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations. We then compared hospitalizations with CDI as a secondary diagnosis to non-CDI hospitalizations by stratifying hospitalizations based on principal diagnosis and then using generalized linear models to compare LOS and in-hospital costs, and logistic regression for in-hospital deaths, adjusting for age and sex. RESULTS: There were 641 CDI hospitalizations during 2006-2012. The average LOS was 17 days; the average cost per hospitalization was AUD 12,704; and in 7.3% of admissions (47 out of 641) the patient died. After adjusting for age and sex, hospitalizations with CDI were associated with longer LOS, higher costs, and a greater proportion of in-hospital deaths compared with hospitalizations with similar principal diagnosis but without CDI. CONCLUSIONS:CDI places additional burden on the Australian hospital system, with CDIpatients having relatively lengthy hospital stays and high costs.
Authors: Uffe Christian Braae; Frederik Trier Møller; Rikke Ibsen; Steen Ethelberg; Jakob Kjellberg; Kåre Mølbak Journal: Front Public Health Date: 2020-11-26