Healthcare Resource Utilization for Recurrent Clostridium difficile Infection in a Large University Hospital in Houston, Texas

被引:21
作者
Aitken, Samuel L. [1 ,2 ]
Joseph, Tiby B. [2 ]
Shah, Dhara N. [1 ,2 ]
Lasco, Todd M. [2 ]
Palmer, Hannah R. [2 ]
DuPont, Herbert L. [1 ,2 ,3 ,4 ]
Xie, Yang [5 ]
Garey, Kevin W. [1 ,2 ,3 ]
机构
[1] Univ Houston, Coll Pharm, Houston, TX 77030 USA
[2] Baylor St Lukes Med Ctr, Houston, TX USA
[3] Univ Texas Houston, Sch Publ Hlth, Houston, TX USA
[4] Baylor Coll Med, Houston, TX 77030 USA
[5] Merck & Co Inc, Whitehouse Stn, NJ USA
关键词
EPIDEMIOLOGY; DISEASE; COSTS;
D O I
10.1371/journal.pone.0102848
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: There are limited data examining healthcare resource utilization in patients with recurrent Clostridium difficile infection (CDI). Methods: Patients with CDI at a tertiary-care hospital in Houston, TX, were prospectively enrolled into an observational cohort study. Recurrence was assessed via follow-up phone calls. Patients with one or more recurrence were included in this study. The location at which healthcare was obtained by patients with recurrent CDI was identified along with hospital length of stay. CDI-attributable readmissions, defined as a positive toxin test within 48 hours of admission and a primary CDI diagnosis, were also assessed. Results: 372 primary cases of CDI were identified of whom 64 (17.2%) experienced at least one CDI recurrence. Twelve of 64 patients experienced 18 further episodes of CDI recurrence. Of these 64 patients, 33 (50.8%) patients with recurrent CDI were readmitted of which 6 (18.2%) required ICU care, 29 (45.3%) had outpatient care only, and 2 (3.1%) had an ED visit. Nineteen (55.9%) readmissions were defined as CDI-attributable. For patients with CDI-attributable readmission, the average length of stay was 666 days. Conclusion: Recurrent CDI leads to significant healthcare resource utilization. Methods of reducing the burden of recurrent CDI should be further studied.
引用
收藏
页数:5
相关论文
共 12 条
[1]   COMPARISON OF 3 ENZYME IMMUNOASSAYS, A CYTOTOXICITY ASSAY, AND TOXIGENIC CULTURE FOR DIAGNOSIS OF CLOSTRIDIUM-DIFFICILE ASSOCIATED DIARRHEA [J].
BARBUT, F ;
KAJZER, C ;
PLANAS, N ;
PETIT, JC .
JOURNAL OF CLINICAL MICROBIOLOGY, 1993, 31 (04) :963-967
[2]   Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) [J].
Cohen, Stuart H. ;
Gerding, Dale N. ;
Johnson, Stuart ;
Kelly, Ciaran P. ;
Loo, Vivian G. ;
McDonald, L. Clifford ;
Pepin, Jacques ;
Wilcox, Mark H. .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2010, 31 (05) :431-455
[3]   Short- and long-term attributable costs of Clostridium difficile -: Associated disease in nonsurgical inpatients [J].
Dubberke, Erik R. ;
Reske, Kimberly A. ;
Olsen, Margaret A. ;
McDonald, L. Clifford ;
Fraser, Victoria J. .
CLINICAL INFECTIOUS DISEASES, 2008, 46 (04) :497-504
[4]  
Dubberke ER, 2014, INFECT CONT HOSP EP, V35, P628, DOI [10.1017/S0899823X00193857, 10.1086/676023]
[5]   Predictors of First Recurrence of Clostridium difficile Infection: Implications for Initial Management [J].
Eyre, David W. ;
Walker, Sarah ;
Wyllie, David ;
Dingle, Kate E. ;
Griffiths, David ;
Finney, John ;
O'Connor, Lily ;
Vaughan, Alison ;
Crook, Derrick W. ;
Wilcox, Mark H. ;
Peto, Timothy E. A. .
CLINICAL INFECTIOUS DISEASES, 2012, 55 :S77-S87
[6]   The rate and cost of hospital readmissions for preventable conditions [J].
Friedman, B ;
Basu, J .
MEDICAL CARE RESEARCH AND REVIEW, 2004, 61 (02) :225-240
[7]   Economic healthcare costs of Clostridium difficile infection: a systematic review [J].
Ghantoji, S. S. ;
Sail, K. ;
Lairson, D. R. ;
DuPont, H. L. ;
Garey, K. W. .
JOURNAL OF HOSPITAL INFECTION, 2010, 74 (04) :309-318
[8]   Assessment of treatment patterns and patient outcomes before vs after implementation of a severity-based Clostridium difficile infection treatment policy [J].
Jardin, C. G. M. ;
Palmer, H. R. ;
Shah, D. N. ;
Le, F. ;
Beyda, N. D. ;
Jiang, Z. ;
Garey, K. W. .
JOURNAL OF HOSPITAL INFECTION, 2013, 85 (01) :28-32
[9]  
Kelly Ciaran P, 2008, N Engl J Med, V359, P1932, DOI 10.1056/NEJMra0707500
[10]   Epidemiology and Healthcare Costs of Incident Clostridium difficile Infections Identified in the Outpatient Healthcare Setting [J].
Kuntz, Jennifer L. ;
Johnson, Eric S. ;
Raebel, Marsha A. ;
Petrik, Amanda F. ;
Yang, Xiuhai ;
Thorp, Micah L. ;
Spindel, Steven J. ;
Neil, Nancy ;
Smith, David H. .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2012, 33 (10) :1031-1038