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J Investig Med. 2012 Feb;60(2):529-32. doi: 10.2310/JIM.0b013e318242b313.

Clostridium difficile infection is associated with poor outcomes in end-stage renal disease.

Author information

1
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.

Abstract

OBJECTIVE:

To investigate the association of Clostridium difficile infection (CDI) with the outcomes of hospitalized patients with end-stage renal disease (ESRD).

METHODS:

We extracted all adult cases with a discharge diagnosis of ESRD or CDI from the United States Nationwide Inpatient Sample 2009 database. Outcome variables (mortality, length of hospital stay [LOS], and hospitalization charges), demographic information, and comorbidity data were collected. Data were evaluated by univariate and multiple regression analyses.

RESULTS:

We identified 184,139 cases with ESRD of which 2.8% had CDI. Comparison of patients with ESRD + CDI to those with only ESRD revealed in-hospital mortality (13.2% vs 5.3%; P < 0.001), LOS (17.3 vs 7.1 days; P < 0.001), and charges ($124,846 vs $56,663; P < 0.001) to be more than 2-fold greater. In the ESRD cohort (ESRD only and ESRD + CDI), CDI was independently associated with greater mortality (adjusted odds ratio, 2.15; 95% CI, 2.07-2.24; P < 0.001), longer LOS (mean difference, 9.4 days; 95% CI, 9.2-9.5; P < 0.001), and higher charges (mean difference, $62,824; 95% CI, 61,615-64,033; P < 0.001).

CONCLUSIONS:

Clostridium difficile infection is associated with significantly worse outcomes in hospitalized patients with ESRD.

PMID:
22222233
DOI:
10.2310/JIM.0b013e318242b313
[Indexed for MEDLINE]

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