Objective:The primary study aim was to describe all direct healthcare costs associated with Clostridioides difficile infection (CDI), both in and out of the hospital, in patients with hematologic malignancies in the United States.Design:A retrospective analysis was conducted utilizing data from US databases of Truven Health Analytics.Patients:We analyzed health insurance claims between January 2014 and December 2017 of patients diagnosed with hematological cancer: acute myeloid leukemia (AML), acute lymphoblastic leukemia, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma (NHL).Methods:Patients with CDI after cancer diagnosis (CDI+, cases) were matched with patients without CDI reported (CDI−, controls). Matched cases and controls were compared to identify the CDI-associated costs in the 90 days following the onset of CDI.Results:We matched 622 CDI+ patients with 11,111 CDI− patients. NHL (41.7%) and AML (30.9%) were the predominant underlying diseases in the CDI+ groups. During study period, the average time in-hospital of CDI+ patients was 23.1 days longer than for CDI− patients (P < 2×10−16). Overall, CDI onset increased costs of care by an average of US$57,159 per patient (P = 6×10−12), mainly driven by hospital costs.Conclusions:This study confirms the significant economic burden associated with CDI in the United States, especially in patients with hematological malignancies. These findings highlight the need for prevention of CDI in this specific patient population.

中文翻译：

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美国血液系统恶性肿瘤患者艰难梭菌感染的经济负担：病例对照研究

目的：主要研究目的是描述所有与相关的直接医疗保健费用艰难梭菌美国血液系统恶性肿瘤患者院内和院外感染 (CDI)和2017年12月诊断为血液系统癌症的患者：急性髓性白血病（AML）、急性淋巴细胞白血病、霍奇金淋巴瘤和非霍奇金淋巴瘤（NHL）。方法：将癌症诊断后CDI患者（CDI+，例）与患者进行匹配没有报告 CDI（CDI-，控制）。比较匹配的病例和对照，以确定 CDI 发病后 90 天内与 CDI 相关的费用。结果：我们匹配了 622 名 CDI+ 患者和 11,111 名 CDI- 患者。NHL (41.7%) 和 AML (30. 9%）是 CDI+ 组的主要潜在疾病。在研究期间，CDI+ 患者的平均住院时间比 CDI- 患者长 23.1 天（磷< 2×10-16）。总体而言，CDI 发病使每位患者的护理成本平均增加了 57,159 美元（磷= 6×10-12)，主要由医院成本驱动。结论：本研究证实了与美国 CDI 相关的重大经济负担，尤其是血液系统恶性肿瘤患者。这些发现强调了在这一特定患者群体中预防 CDI 的必要性。