Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
J Investig Med. 2012 Feb;60(2):529-32. doi: 10.2310/JIM.0b013e318242b313.
To investigate the association of Clostridium difficile infection (CDI) with the outcomes of hospitalized patients with end-stage renal disease (ESRD).
We extracted all adult cases with a discharge diagnosis of ESRD or CDI from the United States Nationwide Inpatient Sample 2009 database. Outcome variables (mortality, length of hospital stay [LOS], and hospitalization charges), demographic information, and comorbidity data were collected. Data were evaluated by univariate and multiple regression analyses.
We identified 184,139 cases with ESRD of which 2.8% had CDI. Comparison of patients with ESRD + CDI to those with only ESRD revealed in-hospital mortality (13.2% vs 5.3%; P < 0.001), LOS (17.3 vs 7.1 days; P < 0.001), and charges ($124,846 vs $56,663; P < 0.001) to be more than 2-fold greater. In the ESRD cohort (ESRD only and ESRD + CDI), CDI was independently associated with greater mortality (adjusted odds ratio, 2.15; 95% CI, 2.07-2.24; P < 0.001), longer LOS (mean difference, 9.4 days; 95% CI, 9.2-9.5; P < 0.001), and higher charges (mean difference, $62,824; 95% CI, 61,615-64,033; P < 0.001).
Clostridium difficile infection is associated with significantly worse outcomes in hospitalized patients with ESRD.
探讨艰难梭菌感染（CDI）与终末期肾病（ESRD）住院患者结局的关系。
我们从美国全国住院患者样本 2009 数据库中提取了所有患有 ESRD 或 CDI 出院诊断的成年病例。收集了结局变量（死亡率、住院时间[LOS]和住院费用）、人口统计学信息和合并症数据。通过单变量和多变量回归分析进行数据评估。
我们确定了 184139 例 ESRD 患者，其中 2.8%患有 CDI。与仅患有 ESRD 的患者相比，患有 ESRD+CDI 的患者的院内死亡率（13.2%对 5.3%；P<0.001）、LOS（17.3 对 7.1 天；P<0.001）和费用（$124846 对$56663；P<0.001）高出 2 倍以上。在 ESRD 队列（仅 ESRD 和 ESRD+CDI）中，CDI 与更高的死亡率（调整后的优势比，2.15；95%CI，2.07-2.24；P<0.001）、更长的 LOS（平均差异，9.4 天；95%CI，9.2-9.5；P<0.001）和更高的费用（平均差异，$62824；95%CI，61615-64033；P<0.001）独立相关。
艰难梭菌感染与 ESRD 住院患者的预后显著恶化相关。
