Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

Volume 13, Number 2, April 2020, pages 53-57


Outcomes of Clostridioides difficile Infection in Patients With Liver Cirrhosis: A Nationwide Study

Figure

Figure 1.
Figure 1. Population derivation.

Tables

Table 1. Baseline Characteristics of Index Hospitalizations Secondary to CDI
 
VariablesNo cirrhosisCirrhosisTotalP value
AMA: against medical advice; CDI: Clostridioides difficile infection.
Patient level variables
  Mean age67.4 ± 17.260.3 ± 12.8< 0.001
  Gender< 0.0001
    Men521,505 (41.0%)28,900 (54.8%)550,405 (41.5%)
    Women753,245 (59.0%)23,865 (45.2%)777,110 (58.5%)
  Race< 0.0001
    White909,590 (71.4%)35,085 (66.5%)944,675 (71.2%)
    Black157,500 (12.3%)5,785 (11.0%)163,285 (12.3%)
    Others207,725 (16.3%)11,890 (22.5%)219,615 (16.5%)
  Comorbidities
    Obesity145,400 (11.4%)6,005 (11.4%)151,405 (11.4%)0.8606
    Congestive heart failure255,360 (20.0%)8,835 (16.7%)264,195 (20.0%)< 0.0001
    History of hypertension787,230 (61.8%)27,350 (51.8%)814,580 (61.4%)< 0.0001
    Diabetes280,525 (22.0%)13,485 (25.6%)294,010 (22.2%)< 0.0001
    Alcohol abuse48,320 (3.8%)19,950 (37.8%)68,270 (5.1%)< 0.0001
    Toxic megacolon1,925 (0.2%)50 (0.1%)1,975 (0.2%)0.001
    Acquired immune deficiency syndrome5,635 (0.4%)535 (1.0%)6,170 (0.5%)< 0.0001
    Metastatic cancer53,275 (4.2%)1,165 (2.2%)54,440 (4.1%)< 0.0001
    Solid tumor without metastasis49,580 (3.9%)2,520 (4.8%)52,100 (4.0%)< 0.0001
    Renal failure332,890 (26.1%)13,930 (26.4%)346,820 (26.1%)0.1406
    Chronic lung disease313,575 (24.6%)12,305 (23.3%)325,880 (24.6%)< 0.0001
  Primary payer< 0.0001
    Medicare/medicaid992,350 (77.9%)38,180 (72.4%)1,030,530 (77.6%)
    Private insurance224,575 (17.6%)10,300 (19.5%)234,875 (17.7%)
    Self-pay/others57,615 (4.5%)4,265 (8.1%)61,880 (4.7%)
Hospital characteristics
  Hospital bed size< 0.0001
    Small193,270 (15.2%)6,770 (12.8%)200,040 (15.1%)
    Medium344,310 (27.0%)14,080 (26.7%)358,390 (27.0%)
    Large737,250 (57.8%)31,915 (60.5%)769,165 (57.9%)
  Hospital location/teaching status< 0.0001
    Rural115,830 (9.1%)2,995 (5.7%)118,825 (9.0%)
    Urban nonteaching416,975 (32.7%)14,905 (28.3%)431,880 (32.5%)
    Urban teaching742,025 (58.2%)34,865 (66.1%)776,890 (58.5%)
  Disposition< 0.0001
    Home465,470 (36.5%)20,885 (39.6%)486,355 (36.7%)
    Facility/others713,590 (56.0%)25,855 (49.0%)739,445 (55.7%)
    AMA7,040 (0.6%)685 (1.3%)7,725 (0.6%)
    Died88,190 (6.9%)5,315 (10.1%)93,505 (7.0%)
  Cost< 0.001
    Mean23,055.6 ± 39,926.926,535.3 ± 41,379.2
  Length of stay< 0.001
    Mean10.4 ± 13.211.0 ± 12.9

 

Table 2. Adjusted Mortality of CDI Admissions
 
Outcomes (mortality)Adjusted odds ratioLower limitUpper limitP value
Adjusted with age, gender, hospital level characteristics (hospital type, bed-size) and comorbidities (obesity, congestive heart failure, hypertension, diabetes mellitus, metastatic cancer, immunodeficiency, alcohol abuse, toxic megacolon, renal failure, chronic lung disease). CDI: Clostridioides difficile infection.
Without cirrhosisReferenceReferenceReferenceReference
With cirrhosis1.651.531.77< 0.001