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Clostridioides (formerly Clostridium) difficile infection during hospitalization increases the likelihood of non-home patient discharge.
Clin Infect Dis. 2018 Sep 11;:
Authors: Reveles KR, Dotson KM, Gonzales-Luna A, Surati D, Endres BT, Alam MJ, Garey KW
Abstract
Background: Clostridioides (formerly Clostridium) difficile infection (CDI) is associated with significant morbidity and mortality, including frequent hospitalizations. However, the impact of CDI post-hospital discharge is poorly understood. The purpose of this study was to assess patient discharge disposition and understand CDI-related risk factors for non-home discharge.
Methods: Using a nationally representative database of Veterans Health Administration (VHA) patients (2003-2014) and a validation database from hospitalized non-VHA patients in Houston, Texas, admission and discharge disposition was obtained for patients with CDI and matched controls. Incidence of and clinical/microbiologic risk factors for non-home discharge were assessed using these databases.
Results: A total of 15,173 VHA patients with CDI and 48,599 non-CDI control patients originally admitted from the community were included. Significantly more patients with CDI were discharged to a non-home location (18%) compared to controls (8%; p<0.0001), most commonly hospice/death (12%) or nursing home/long-term care facility (6%). Results were confirmed using a propensity matched analysis and a validation cohort of 1,941 hospitalized patients with CDI in Houston, TX. Age, comorbidities, severe CDI, and ribotypes F027, F001, and F053-163 were associated with a non-home discharge (p<0.05 for all).
Conclusions: Hospitalized patients with CDI frequently required a higher level of medical care residence at discharge compared to non-CDI patients. Risk factors for discharge to a higher level of care included CDI disease severity and variables associated with recurrent CDI.
PMID: 30204878 [PubMed - as supplied by publisher]