Impact of Clostridium difficile recurrence on hospital readmissions.
BACKGROUND
The impact of recurrent Clostridium difficile infections (CDIs) on hospital readmissions is unknown. The objective of this study was to determine whether recurrent CDI was independently associated with the number of hospital readmissions and days readmitted.


METHODS
We performed a retrospective cohort study at an academic, urban, tertiary care hospital. Data were collected from electronic medical records and supplemented with chart review. CDI patients were followed for 180 days to ascertain the number of hospital readmissions and total days readmitted. Univariate and multivariable negative binomial regression models were used to evaluate factors, including CDI recurrence, associated with hospital readmissions.


RESULTS
The study included 3,950 patients with CDI from 2003-2009, including 413 patients with recurrent CDI. Recurrent CDI patients were significantly more likely to have at least 1 readmission (85% vs 41%; P < .001) and had more days readmitted (mean = 18.6 vs 7.6; P < .001) than patients without recurrent CDI. In multivariable analysis, recurrent CDI was independently associated with number of readmissions (rate ratio = 2.54; 95% confidence interval [CI], 2.21-2.91) and days readmitted (rate ratio = 3.97; 95% CI, 3.11-5.08) after adjustment for demographics, comorbidities, and medications.


CONCLUSION
Recurrent CDI patients are significantly more likely than patients without a recurrence to be readmitted and spend increased time readmitted to the hospital.
['Olsen|Margaret A|MA|', 'Yan|Yan|Y|', 'Reske|Kimberly A|KA|', 'Zilberberg|Marya|M|', 'Dubberke|Erik R|ER|']
D000617:Aminoglycosides D000900:Anti-Bacterial Agents D015780:Carbapenems D002511:Cephalosporins D016360:Clostridioides difficile D003015:Clostridium Infections D024841:Fluoroquinolones D006801:Humans D007362:Intensive Care Units D000069349:Linezolid D015999:Multivariate Analysis D010359:Patient Readmission D012008:Recurrence D012044:Regression Analysis D012189:Retrospective Studies D014640:Vancomycin
Clostridium difficile Recurrence Readmission Cohort Epidemiology