Clostridium difficile infection in hospitalized liver transplant patients: A nationwide analysis.
Liver Transpl. 2012 Apr 14;
Authors: Ali M, Ananthakrishnan AN, Ahmad S, Kumar N, Kumar G, Saeian K
INTRODUCTION: Incidence of Clostridium difficile infection (CDI) is increasing among hospitalized patients. Liver transplant patients are at higher risk for acquiring CDI. Small, single-center studies, but no nation-wide analyses, have assessed this association. METHODS: We used the Healthcare Cost and Utilization Project- Nationwide Inpatient Sample (HCUP-NIS) from years 2004-2008 for this retrospective cross sectional study. Patients with any discharge diagnosis of liver transplant comprised the study population and were identified using ICD-9-CM codes. Those with a discharge diagnosis of CDI were considered cases. Our primary outcomes were prevalence of CDI and effect of CDI on inpatient mortality. Our secondary outcomes included length of stay and hospitalization charges. Regression analysis was used to derive odds ratios adjusted for potential confounders. RESULTS: There were 193,714 discharges with a diagnosis of liver transplant from 2004-2008. Prevalence of CDI was 2.7% in liver transplant population compared to 0.9% in non liver transplant population (p <0.001). Most of the liver transplant patients were in the 50-64 age group. Liver transplant patients were at higher odds of developing CDI (OR 2.88, 95% CI 2.68-3.10). Increasing age, increasing comorbidity, IBD and NG tube placement were also independent risk factors for CDI. CDI in liver transplant was associated with a higher mortality, 5.5% as compared to 2.3% in liver transplant only population (adjusted OR 1.7, 95% CI 1.3-2.2). CONCLUSIONS: Liver transplant patients have a higher prevalence of CDI as compared to non liver transplant patients (2.7% vs. 0.9%).CDI was an independent risk factor for mortality in liver transplant population. © 2012 American Association for the Study of Liver Diseases.
PMID: 22505356 [PubMed - as supplied by publisher]