Clostridium difficile infection (CDI) is one of the most common healthcare-associated infections. Hospitalized patients are at increased risk for morbidity and mortality related to CDI. Prior studies suggested an increased risk for recurrent CDI in patients with concurrent diverticulitis. We conducted this study to evaluate the outcomes of CDI in patients admitted for acute diverticulitis.
The National Inpatient Sample (NIS) database was queried for CDI admissions using the International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] codes 008.45 between January 2012 and September 2015. ICD-9-CM codes 562.11 and 562.13 were used to identify patients with a current diagnosis of acute diverticulitis. We looked at mortality, length of stay, and cost of hospitalization as the primary outcomes.
Our study included 1,327,595 patients who were admitted for CDI between 2012 and 2105. 31010 patients (2.34%) had a concurrent diagnosis of acute diverticulitis. The mean age for patients with and without diverticulitis was 69 and 67, respectively. The in-hospital mortality was lower in patients with acute diverticulitis [adjusted Odd Ratio (aOR): 0.58, 95% CI: 0.51-0.66 p< 0.001]. Also, the length of stay was shorter, and the cost of hospitalization was lower in patients with acute diverticulitis.
The in-hospital mortality is lower in patients with CDI and concurrent acute diverticulitis. The observed results are different from prior study and might be attributed to a higher burden of the normal flora that competes and potentially reduce the severity of CDI. Also, the wide utilization of antibiotic stewardship programs across many hospitals nationwide might have affected the results.
Table 1: Baseline Characteristics of CDI index hospitalizations
Abubaker Abdalla indicated no relevant financial relationships.
Wesam Taha indicated no relevant financial relationships.
M. Caroline Burton indicated no relevant financial relationships.
Nageshwara Gullapalli indicated no relevant financial relationships.