Decreasing Clostridium difficile-Associated Fatality Rates Among Hospitalized Patients in the United States:...

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Clostridium difficile infection (CDI) has become a significant public health concern in the U.S. over the past two decades.
• Trends in CDI-related mortality, hospital stays, and costs require ongoing examination.

Purpose of the Study:

• To analyze trends in Clostridium difficile infection (CDI) fatality rates, hospital length of stay, and hospital charges in the United States.
• To stratify these trends by age groups due to varying risks associated with CDI.

Main Methods:

• Utilized data from the National Inpatient Sample (NIS) database from 2004 to 2014.
• Identified patients with a primary diagnosis of CDI.
• Analyzed in-hospital fatality rates, mean hospital length of stay, and mean hospital charges, stratified by age.

Main Results:

• CDI discharges increased from 19.9 to 33.8 per 100,000 persons between 2004 and 2014.
• The overall in-hospital fatality rate for CDI decreased by over 50%, from 3.6% to 1.6% (P < .001).
• Hospital length of stay decreased from 6.9 to 5.8 days (P < .001), while hospital charges increased from $24,535 to $35,898 (P < .001).

Conclusions:

• In-hospital fatality associated with Clostridium difficile infection has decreased more than 2-fold in the United States over the last decade.
• These improvements occurred despite a documented increase in CDI infection rates, suggesting enhanced treatment or management strategies.