Clostridium difficile colitis in patients undergoing lumbar spine surgery

Area of Science:

• Infectious Diseases
• Neurosurgery
• Health Services Research

Background:

• Clostridium difficile colitis is an increasing concern in hospitalized patients, impacting outcomes.
• Limited data exist on Clostridium difficile infection (CDI) rates and consequences following lumbar spine surgery.

Purpose of the Study:

• To investigate the incidence, comorbidities, and healthcare resource impact of CDI in patients undergoing lumbar spine surgery.

Main Methods:

• Retrospective analysis of the Nationwide Inpatient Sample (2002-2011).
• Inclusion based on ICD-9-CM codes for lumbar spine surgery for degenerative diagnoses.
• Multivariable analyses to identify factors associated with CDI incidence and mortality risk.

Main Results:

• CDI incidence was 0.11% post-lumbar spine surgery.
• Infected patients were older and had more comorbidities.
• CDI increased hospital stay by 8 days, doubled charges, and raised mortality from 0.11% to 4%.

Conclusions:

• CDI after lumbar spine surgery is associated with a 36.4-fold increase in mortality.
• Annual management costs for CDI in this population approximate $10.6 million.
• Preventing CDI in lumbar spine surgery patients is critical due to associated longer stays, higher costs, and increased mortality.