RT Journal Article
SR Electronic
T1 Clostridium difficile Infection Is Associated With Poor Outcomes in End-Stage Renal Disease
JF Journal of Investigative Medicine
JO J Investig Med
FD BMJ Publishing Group Ltd
SP 529
OP 532
DO 10.2310/JIM.0b013e318242b313
VO 60
IS 2
A1 Chaitanya Pant
A1 Abhishek Deshpande
A1 Michael P. Anderson
A1 Thomas J. Sferra
YR 2012
UL http://hw-f5-jim.highwire.org/content/60/2/529.abstract
AB 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.