Ana López-de-Andrés1, María D Esteban-Vasallo2, Javier de Miguel-Díez3, Valentín Hernández-Barrera1, José M de Miguel-Yanes4, Manuel Méndez-Bailón5, Rodrigo Jiménez-García1. 1. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain. 2. Madrid Regional Health Authority, Public Health Directorate, Madrid, Spain. 3. Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain. 4. Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain. 5. Internal Medicine Department, Hospital Universitario Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.
Abstract
AIM: To examine incidence and in-hospital outcomes of Clostridium difficile infection (CDI) among patients with type 2 diabetes (T2DM); compare clinical variables among T2DM patients with matched non-T2DM patients hospitalised with CDI and identify factors associated with in-hospital mortality (IHM) among T2DM patients. METHODS: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients that had CDI as primary or secondary diagnosis in their discharge report. For each T2DM patient, we selected a gender, age, readmission status and year-matched non-diabetic patient. RESULTS: We identified 44 695 patients with CDI (21.19% with T2DM). We matched 3040 and 5987 couples with a primary and secondary diagnosis of CDI, respectively. Incidence of CDI was higher in T2DM patients (IRR per hospital admission 1.12; 95% CI 1.09-1.14, IRR per population 1.26; 95% CI 1.22-1.29). IHM decreased over time in T2DM and non-T2DM patients (from 15.36% and 13.35%, in 2001-2003 to 10.36% and 11.73% in 2013-2015), despite a concomitant increase in CDI diagnoses overtime. Among those with CDI as secondary diagnosis IHM was higher in nondiabetic 16.17% than in T2DM patients 13.19% (P < 0.001). In T2DM patients higher mortality rates were associated with older age, comorbidities, severe CDI, and readmission. Primary diagnosis of CDI was associated with lower IHM (OR 0.71; 95% CI 0.60-0.84) than secondary diagnosis. CONCLUSIONS: Incidence of CDI was higher in T2DM patients. IHM decreased over time, regardless of the existence or not of T2DM. IHM was significantly lower in T2DM patients with CDI as primary diagnosis than non diabetic patients.
AIM: To examine incidence and in-hospital outcomes of Clostridium difficileinfection (CDI) among patients with type 2 diabetes (T2DM); compare clinical variables among T2DM patients with matched non-T2DM patients hospitalised with CDI and identify factors associated with in-hospital mortality (IHM) among T2DM patients. METHODS: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients that had CDI as primary or secondary diagnosis in their discharge report. For each T2DM patient, we selected a gender, age, readmission status and year-matched non-diabeticpatient. RESULTS: We identified 44 695 patients with CDI (21.19% with T2DM). We matched 3040 and 5987 couples with a primary and secondary diagnosis of CDI, respectively. Incidence of CDI was higher in T2DM patients (IRR per hospital admission 1.12; 95% CI 1.09-1.14, IRR per population 1.26; 95% CI 1.22-1.29). IHM decreased over time in T2DM and non-T2DM patients (from 15.36% and 13.35%, in 2001-2003 to 10.36% and 11.73% in 2013-2015), despite a concomitant increase in CDI diagnoses overtime. Among those with CDI as secondary diagnosis IHM was higher in nondiabetic 16.17% than in T2DM patients 13.19% (P < 0.001). In T2DM patients higher mortality rates were associated with older age, comorbidities, severe CDI, and readmission. Primary diagnosis of CDI was associated with lower IHM (OR 0.71; 95% CI 0.60-0.84) than secondary diagnosis. CONCLUSIONS: Incidence of CDI was higher in T2DM patients. IHM decreased over time, regardless of the existence or not of T2DM. IHM was significantly lower in T2DM patients with CDI as primary diagnosis than non diabeticpatients.
Authors: Ana López-de-Andrés; Romana Albaladejo-Vicente; Domingo Palacios-Ceña; David Carabantes-Alarcon; José Javier Zamorano-Leon; Javier de Miguel-Diez; Marta Lopez-Herranz; Rodrigo Jiménez-García Journal: Int J Environ Res Public Health Date: 2020-12-16 Impact factor: 3.390
Authors: Jacek Czepiel; Marcela Krutova; Assaf Mizrahi; Nagham Khanafer; David A Enoch; Márta Patyi; Aleksander Deptuła; Antonella Agodi; Xavier Nuvials; Hanna Pituch; Małgorzata Wójcik-Bugajska; Iwona Filipczak-Bryniarska; Bartosz Brzozowski; Marcin Krzanowski; Katarzyna Konturek; Marcin Fedewicz; Mateusz Michalak; Lorra Monpierre; Philippe Vanhems; Theodore Gouliouris; Artur Jurczyszyn; Sarah Goldman-Mazur; Dorota Wultańska; Ed J Kuijper; Jan Skupień; Grażyna Biesiada; Aleksander Garlicki Journal: Antibiotics (Basel) Date: 2021-03-13