High 30-day readmission rates associated with Clostridiumdifficile infection

Authors

• Elijah Verheyen, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai West-St. Luke's Hospital, New York, NY. Electronic address: elijah.verheyen@mountsinai.org.
• Vijay Dalapathi, Division of Gastroenterology, University of Rochester Medical Center, Rochester, NY.
• Shilpkumar Arora, Department of Medicine, Guthrie Clinic, Sayre, PA.
• Kalpesh Patel, Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ.
• Pavan Kumar Mankal, Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai West-St. Luke's Hospital, New York, NY.
• Varun Kumar, Department of Medicine, University of South Florida, Tampa, FL.
• Edward Lung, Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai West-St. Luke's Hospital, New York, NY.
• Donald P. Kotler, Division of Gastroenterology, Department of Medicine, Einstein College of Medicine, Jacobi Medical Center, Bronx, NY.
• Ari Grinspan, Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY.

Document Type

Article

Abstract

BACKGROUND: Clostridium difficile infection (CDI) is a leading cause of community-onset and healthcare-associated infection, with high recurrence rates, and associated high morbidity and mortality. We report national rates, leading causes, and predictors of hospital readmission for CDI. METHODS: Retrospective study of data from the 2013 Nationwide Readmissions Database of patients with a primary diagnosis of CDI and re-hospitalization within 30-days. A multivariate regression model was used to identify predictors of readmission. RESULTS: Of 38,409 patients admitted with a primary diagnosis of CDI, 21% were readmitted within 30-days, and 27% of those patients were readmitted with a primary diagnosis of CDI. Infections accounted for 47% of all readmissions. Female sex, anemia/coagulation defects, renal failure/electrolyte abnormalities and discharge to home (versus facility) were 12%, 13%, 15%, 36%, respectively, more likely to be readmitted with CDI. CONCLUSIONS: We found that 1-in-5 patients hospitalized with CDI were readmitted to the hospital within 30-days. Infection comprised nearly half of these readmissions, with CDI being the most common etiology. Predictors of readmission with CDI include female sex, history of renal failure/electrolyte imbalances, anemia/coagulation defects, and being discharged home. CDI is associated with a high readmission risk, with evidence of several predictive risks for readmission.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Anemia (complications); Clostridium Infections (complications); Female; Humans; Kidney Diseases (complications); Male; Middle Aged; Patient Readmission; Retrospective Studies; Risk Factors; Young Adult

Publication Date

8-1-2019

Publication Title

American journal of infection control

E-ISSN

1527-3296

Volume

47

Issue

8

First Page

922

Last Page

927

PubMed ID

30777388

Digital Object Identifier (DOI)

10.1016/j.ajic.2019.01.007

Recommended Citation

Verheyen, Elijah; Dalapathi, Vijay; Arora, Shilpkumar; Patel, Kalpesh; Mankal, Pavan Kumar; Kumar, Varun; Lung, Edward; Kotler, Donald P.; and Grinspan, Ari, "High 30-day readmission rates associated with Clostridiumdifficile infection" (2019). Neurology. 2074.
https://scholar.barrowneuro.org/neurology/2074