Background

The healthcare burden of Clostridium (Clostridioides) difficile infection (CDI) is high but not fully characterized.

Aim

To assess hospitalization costs, length of hospital stay (LOS) and in-hospital mortality attributable to CDI in the USA by analysing nationwide hospital discharge records over the 2012–2016 period.

Methods

A retrospective, observational study based on the Truven Health MarketScan Hospital Drug Database was conducted, in which 46,097 inpatient stays with a diagnosis of CDI were analysed. Costs, LOS and in-hospital mortality were studied for patients with either a principal or secondary (comorbidity) diagnosis of CDI, and for patients re-admitted because of CDI. If CDI was a comorbidity, its attributable burden was estimated by coarsened exact matching, comparing 17,273 CDI stays with 84,164 stays in a control group without a CDI diagnosis.

Findings

Inpatients for whom CDI was the main reason for hospitalization incurred mean costs of US$10,528 and an average LOS of 5.9 days. For CDI as a comorbidity, the mean additional cost was US$11,938 and the additional LOS was 4.4 days. CDI also increased the in-hospital mortality rate by 4.1%, on average.

Conclusion

This study is consistent with previous publications which demonstrated the high economic burden of CDI for healthcare settings and health insurance systems. When recorded as a comorbidity, CDI significantly increased hospital costs and LOS. These results highlight the need for innovative therapeutic approaches in the prevention and treatment of CDI.

中文翻译：

---

2012年至2016年间美国住院期间艰难梭菌（Clostridioides）感染的负担

背景

艰难梭菌（Clostridioides）艰难梭菌感染（CDI）的医疗保健负担很高，但尚未完全确定。

目的

通过分析2012-2016年期间全国范围内的出院记录，评估美国的住院费用，住院时间（LOS）和归因于CDI的院内死亡率。

方法

进行了基于Truven Health MarketScan医院药物数据库的回顾性观察性研究，其中分析了46,097例住院患者，诊断为CDI。对患有CDI的主要或继发（合并症）诊断的患者以及因CDI而再次入院的患者进行了成本，LOS和院内死亡率的研究。如果CDI是合并症，则通过粗化精确匹配来估计其可归因的负担，将17,273例CDI住院患者与84,164例未进行CDI诊断的对照组进行比较。

发现

以CDI为主要住院原因的住院患者的平均费用为10,528美元，平均LOS为5.9天。对于CDI合并症，平均额外费用为11,938美元，额外LOS为4.4天。CDI还平均使医院内死亡率提高了4.1％。

结论

这项研究与以前的出版物一致，这些出版物证明了CDI对医疗机构和健康保险系统的巨大经济负担。当记录为合并症时，CDI会显着增加医院成本和LOS。这些结果突显了在预防和治疗CDI中需要创新的治疗方法。