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. 2008 Jul;14(7):1031-8.
doi: 10.3201/eid1407.070867.

Attributable outcomes of endemic Clostridium difficile-associated disease in nonsurgical patients

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Attributable outcomes of endemic Clostridium difficile-associated disease in nonsurgical patients

Erik R Dubberke et al. Emerg Infect Dis. 2008 Jul.

Abstract

Data are limited on the attributable outcomes of Clostridium difficile-associated disease (CDAD), particularly in CDAD-endemic settings. We conducted a retrospective cohort study of nonsurgical inpatients admitted for >/=48 hours in 2003 (N = 18,050). The adjusted hazard ratios for readmission (hazard ratio 2.19, 95% confidence interval [CI] 1.87-2.55) and deaths within 180 days (hazard ratio 1.23, 95% CI 1.03-1.46) were significantly different among CDAD case-patients and noncase patients. In a propensity score matched-pairs analysis that used a nested subset of the cohort (N = 706), attributable length of stay attributable to CDAD was 2.8 days, attributable readmission at 180 days was 19.3%, and attributable death at 180 days was 5.7%. CDAD patients were significantly more likely than controls to be discharged to a long-term-care facility or outside hospital. Even in a nonoutbreak setting, CDAD had a statistically significant negative impact on patient illness and death, and the impact of CDAD persisted beyond hospital discharge.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival estimates for cohort (N = 18,050). CDAD, Clostridium difficile–associated disease.
Figure 2
Figure 2
Kaplan-Meier estimates of time until hospital readmission for matched pairs (n = 580). CDAD, Clostridium difficile–associated disease.
Figure 3
Figure 3
Kaplan-Meier survival estimates for matched pairs (n = 706). CDAD, Clostridium difficile–associated disease.

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