Quality of life among patients with community-onset Clostridioides difficile infection treated in the outpatient...

Little is known about the impact of Clostridioides difficile infection (CDI) on health-related quality of life (HRQoL) among adults in the community. We examined the impact of CDI on HRQoL among adults with CDI in the outpatient setting and compared it to HRQoL among patients without CDI.

We conducted a prospective study among adult Kaiser Permanente members ≥50 years with CDI in the outpatient setting (cases) and members ≥45 years who had an outpatient encounter without diarrhea or C. difficile (controls). Cases and controls were not hospitalized within 7 days. Cases and controls completed the EQ-5D-5L at baseline and after 60 days.

Our analyses included 213 adults with CDI and 426 adults without CDI. Adults with and without CDI reported similar perceived health status [median visual analogue scale (VAS) of 80.0 and 81.0, (p = 0.08)] and utility index scores [median of 0.9 for both; (p = 0.16)] before illness. On their worst day, adults with CDI reported lower perceived health status and utility index scores, compared to pre-infection (p < 0.0001). Decrements in median VAS and utility indices among adults with CDI from pre-infection to worst day were significantly greater than decrements among adults without CDI (p < 0.0001 for both). At 60 days, adults with and without CDI had VAS and utility index scores similar to pre-illness levels.

Adults with CDI experienced significant reductions in HRQoL on the worst day of illness that were greater than that experienced by those without CDI. HRQoL among adults with CDI at 60 days was similar to pre-infection levels.