Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease - PubMed (original) (raw)
Comparative Study
doi: 10.1136/gut.2007.128231. Epub 2007 Sep 28.
Affiliations
- PMID: 17905821
- DOI: 10.1136/gut.2007.128231
Comparative Study
Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease
A N Ananthakrishnan et al. Gut. 2008 Feb.
Abstract
Background: Clostridium difficile is an important cause of diarrhoea in hospitalised patients. An increasing number of cases of C difficile colitis occur in patients with inflammatory bowel disease (IBD)-Crohn's disease (CD), ulcerative colitis (UC).
Objective: To estimate the potential excess morbidity and mortality associated with C difficile in hospitalised patients with IBD.
Methods: Data from the Nationwide Inpatient Sample (2003) were analysed and outcomes were examined of patients hospitalised with both C difficile colitis and IBD compared with those hospitalised for either condition alone. The primary outcome was in-hospital mortality. A subgroup analysis was also performed comparing outcomes of C difficile infection in patients with CD and UC.
Results: 2804 discharges were diagnosed as having both C difficile and IBD, 44,400 as having C difficile alone, and 77,366 as having IBD alone. On multivariate analysis, patients in the C difficile-IBD group had a four times greater mortality than patients admitted to hospital for IBD alone (aOR = 4.7, 95% CI 2.9 to 7.9) or C difficile alone (aOR = 2.2, 95% CI 1.4 to 3.4), and stayed in the hospital for three days longer (95% CI 2.3 to 3.7 days). Significantly higher mortality, endoscopy and surgery rates were found in patients with UC compared with CD (p<0.05), but no significant difference in length of stay or median hospital charge between the two groups was seen.
Conclusions: C difficile colitis is associated with a significant healthcare burden in hospitalised patients with IBD and carries a higher mortality than in patients with C difficile without underlying IBD.
Comment in
- Prognosis in Clostridium difficile infection complicating inflammatory bowel disease.
Stone CD. Stone CD. Gut. 2008 Feb;57(2):150-2. doi: 10.1136/gut.2007.137042. Gut. 2008. PMID: 18192450 No abstract available. - Clostridium difficile infection and inflammatory bowel disease: a marker for disease extent?
Powell N, Jung SE, Krishnan B. Powell N, et al. Gut. 2008 Aug;57(8):1183-4; author reply 1184. Gut. 2008. PMID: 18628389 No abstract available.
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