Burden of Hospital-Onset<i>Clostridium difficile</i>Infection in Patients Discharged from Rhode Island Hospitals, 2010–2011: Application of Present on Admission Indicators

Jiang, Yongwen; Viner-Brown, Samara; Baier, Rosa R.

doi:10.1086/670993

Cited by 13 publications

(22 citation statements)

References 16 publications

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“…In hospitalized patients (no particular patient group specifi ed), the mean attributable CDI costs (per patient/admission/episode/infection) ranged from $8,911 to $30,049 ( 34,38,47,58,59,61 ). In addition, 23 studies demonstrated in various diff erent patient populations that CDI can lead to statistically signifi cant higher costs ( 6,37-40,43-45, 49,50,55-60,62-65,67,69,70 ).…”

Section: Discussionmentioning

confidence: 99%

“…Most of the studies based their CDI defi nition on the International Classifi cation of Diseases (ICD)-9 or ICD-10 code for CDI (28 studies, 62% ( 6,8,34,(38)(39)(40)(41)(43)(44)(45)(46)(47)(49)(50)(51)(52)(54)(55)(56)(57)(58)(59)(60)(61)63,65,68,69 )). All ( 4-8,34-73 ) studies included direct costs in their analyses (only one study ( 48 ) also considered indirect costs).…”

Section: Coi Study Characteristicsmentioning

confidence: 99%

“…In addition, 22% (10 studies) indicated the year and currency that costs were evaluated in ( 40,43,45,46,48,52,57,65,67,68 ), 49% (22 studies) presented costs in aggregate and disaggregate form (4)(5)(6)(7)36,(39)(40)(41)44,46,48,52,54,57,59,62,64,66,67,69,72,73 ), 62% (28 studies) calculated descriptive statistics for the cost estimates, along with providing confi dence intervals around the estimates and/or P values ( 4,6,8,34,(37)(38)(39)(40)(41)(42)(43)(44)(45)(48)(49)(50)(56)…”

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

“…In the following patient populations that were studied, statistically signifi cant higher costs were found among CDI patients (vs. a comparison group, where most studies compared to those without CDI): any hospitalization ( 38,(57)(58)(59)70 ); children ( 39,56 ); adults ( 38,40,57 ); individuals aged ≥65 years ( 37,40 ); those with a history of CDI ( 40 ); admitted to the intensive care unit ( 67 ); nonsurgical ( 64 ); surgical ( 69 ); undergoing colon resections ( 55 ), radical cystectomy ( 45 ), digestive tract surgery ( 6 ), or closure of loop ileostomy ( 43 ); undergoing solid-organ ( 49 ) or liver ( 44 ) transplant; have cancer ( 6,45 ); have infl ammatory bowel disease ( 39,40,65 ); have cirrhosis ( 60 ); have renal disease ( 37,40,50 ); on prolonged acute mechanical ventilation ( 63 ); and taking concomitant antibiotics ( 37,40 ).…”

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

“…Most studies met the following quality criteria: mentioned the time horizon for which costs were calculated over (45 studies, 100% (4)(5)(6)(7)(8)), stated the cost outcomes being evaluated (43 studies, 96% (4)(5)(6)(7)(8)34,), reported the resource utilization variables separately from unit costs (40 studies, 89% ( 4-8, 35-52,54-58,60,62-70,72,73 )), described the resource utilization and cost sources (38 studies, 84% (4)(5)(6)8,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(54)(55)(56)(57)(58)(59)(60)(61)(63)(64)(65)(66)(67)(68)(69)(70)(71)…”

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

See 4 more Smart Citations

The Economic Impact of Clostridium difficile Infection: A Systematic Review

Nanwa

Kendzerska

Krahn

et al. 2015

American Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Section: Coi Study Characteristicsmentioning

confidence: 99%

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Coi Studiesmentioning

confidence: 99%

See 3 more Smart Citations

The Economic Impact of Clostridium difficile Infection: A Systematic Review

Nanwa

Kendzerska

Krahn

et al. 2015

American Journal of Gastroenterology

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Incidence and Outcomes Associated WithClostridium difficileInfections

et al. 2020

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IMPORTANCE An understanding of the incidence and outcomes of Clostridium difficile infection (CDI) in the United States can inform investments in prevention and treatment interventions. OBJECTIVE To quantify the incidence of CDI and its associated hospital length of stay (LOS) in the United States using a systematic literature review and meta-analysis. DATA SOURCES MEDLINE via Ovid, Cochrane Library Databases via Wiley, Cumulative Index of Nursing and Allied Health Complete via EBSCO Information Services, Scopus, and Web of Science were searched for studies published in the United States between 2000 and 2019 that evaluated CDI and its associated LOS. STUDY SELECTION Incidence data were collected only from multicenter studies that had at least 5 sites. The LOS studies were included only if they assessed postinfection LOS or used methods accounting for time to infection using a multistate model or compared propensity score-matched patients with CDI with control patients without CDI. Long-term-care facility studies were excluded. Of the 119 full-text articles, 86 studies (72.3%) met the selection criteria. DATA EXTRACTION AND SYNTHESIS Two independent reviewers performed the data abstraction and quality assessment. Incidence data were pooled only when the denominators used the same units (eg, patient-days). These data were pooled by summing the number of hospital-onset CDI incident cases and the denominators across studies. Random-effects models were used to obtain pooled mean differences. Heterogeneity was assessed using the I 2 value. Data analysis was performed in February 2019. MAIN OUTCOMES AND MEASURES Incidence of CDI and CDI-associated hospital LOS in the United States. RESULTS When the 13 studies that evaluated incidence data in patient-days due to hospital-onset CDI were pooled, the CDI incidence rate was 8.3 cases per 10 000 patient-days. Among propensity score-matched studies (16 of 20 studies), the CDI-associated mean difference in LOS (in days) between patients with and without CDI varied from 3.0 days (95% CI, 1.44-4.63 days) to 21.6 days (95% CI, 19.29-23.90 days). CONCLUSIONS AND RELEVANCE Pooled estimates from currently available literature suggest that CDI is associated with a large burden on the health care system. However, these estimates should be interpreted with caution because higher-quality studies should be completed to guide future evaluations of CDI prevention and treatment interventions.

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