Clostridium difficile colitis: factors associated with outcome and assessment of mortality at a national level

Abstract

Background: Previous descriptions of Clostridium difficile colitis (CDC) epidemics may overestimate cost and mortality of CDC.

Methods: An analysis of the 2007 Nationwide Inpatient Sample was performed. Patients with CDC (N = 41,207) were compared to a propensity score-matched cohort of patients without CDC.

Results: Average length of stay was longer for CDC patients by 5 days (p < 0.001). Mortality was higher for the CDC cohort (9.4% vs. 8.6%; p < 0.001) though the absolute difference was small. Mean hospital costs were 56% higher for CDC patients (p < 0.001). Higher odds of death with CDC were associated with small hospitals and self-pay patients. Chronic renal failure and diabetes were associated with lower hospital costs and lower odds of death in the CDC cohort.

Conclusions: CDC is not as deadly of a disease as it may be perceived to be at larger hospitals, and mortality was actually unaffected by certain serious comorbidities. CDC is expensive due to a longer hospital stay.