Among inpatients, ischemic bowel disease predisposes to Clostridium difficile infection with concomitant higher mortality and worse outcomes
| العنوان: | Among inpatients, ischemic bowel disease predisposes to Clostridium difficile infection with concomitant higher mortality and worse outcomes |
|---|---|
| المؤلفون: | Lydie Pani, Adeyinka Charles Adejumo, Olalekan Akanbi |
| المصدر: | European Journal of Gastroenterology & Hepatology. 31:109-115 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Ischemic Bowel Disease, medicine.medical_specialty, Time Factors, Adolescent, Databases, Factual, genetic structures, Cross-sectional study, Risk Assessment, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Prevalence, medicine, Humans, Hospital Mortality, Hospital Costs, Young adult, Healthcare Cost and Utilization Project, Aged, Retrospective Studies, Aged, 80 and over, Inpatients, Hepatology, business.industry, Gastroenterology, Retrospective cohort study, Odds ratio, Length of Stay, Middle Aged, Clostridium difficile, Prognosis, Patient Discharge, United States, Cross-Sectional Studies, Mesenteric Ischemia, 030220 oncology & carcinogenesis, Concomitant, Clostridium Infections, Female, 030211 gastroenterology & hepatology, business |
| الوصف: | Background and aims Clinical conditions resulting in hypoxia, hypoperfusion, anaerobic milieu within the gut, and intestinal epithelial breakdown, such as seen in heart failure, precipitates Clostridium difficile infection (CDI). Given that ischemic bowel disease (IB) typically results in similar changes within the gut, we investigated the relationship between CDI and IB, and the impact of CDI on the clinical outcomes of IB. Patients and methods We initially performed a cross-sectional analysis on the 2014 Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (NIS) patient's discharge records of ages 18 years and older, by estimating the crude and adjusted odds ratio (aOR) of CDI and IB as the outcome and predictor respectively. We then pooled data from the 2012-2014 NIS, identified, and compared mortality (and 15 other outcomes) between three groups: IB+CDI, IB-alone, and CDI-alone (Statistical Analysis System 9.4). Results In the 2014 NIS, records with IB (n=27 609), had higher rate and odds of CDI [3.95 vs. 1.17%, aOR: 1.89 (1.77-2.02)] than records without IB (n=5 879 943). The 2012-2014 NIS contained 1105 IB+CDI, 30 960 IB-alone, and 60 758 CDI-alone groups. IB+CDI had higher mortality [aOR: 1.44 (1.11-1.86)], length of stay [9.59 (9.03-10.20) vs. 6.12 (5.99-6.26) days], cost [$93 257 (82 892-104 919) vs. $63 257 (61 029-65 567)], unfavorable discharge disposition [aOR: 2.24 (1.91-2.64)] and poorer results across most of the other outcomes than IB-alone. Comparable results were found for IB+CDI versus CDI-alone. Conclusion IB is a risk factor for CDI in hospitals. CDI is associated with higher mortality, longer length of stay, higher cost, unfavorable discharge, and many other poorer health outcomes in patients with IB. |
| تدمد: | 0954-691X |
| DOI: | 10.1097/meg.0000000000001273 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7bc470d293a86a46076d0d8b5b55ad71 https://doi.org/10.1097/meg.0000000000001273 |
| رقم الانضمام: | edsair.doi.dedup.....7bc470d293a86a46076d0d8b5b55ad71 |
| قاعدة البيانات: | OpenAIRE |
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