Smith Aaron M, Wuerth Brandon A, Wiemken Timothy L, Arnold Forest W
School of Medicine, University of Louisville, Louisville, KY, USA.
Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA.
Am J Emerg Med. 2015 Feb;33(2):238-43. doi: 10.1016/j.ajem.2014.11.023. Epub 2014 Nov 26.
The objective of the study is to determine the prevalence of Clostridium difficile infection (CDI) presenting to emergency departments (EDs) in the United States. Secondary objectives included defining the burden of CDI.
This is a retrospective, observational cohort study of 2006-2010 Nationwide Emergency Department Sample database of 980 US hospital EDs in 29 states. Prevalence, mortality rate, length of stay, hospital charges, and endemicity were measured.
A total of 474513 patients with CDI-related ED visits were identified. From 2006 to 2010, the prevalence of CDI increased from 26.2 to 33.1 per 100,000 population (P<.001). The number of CDI-related ED cases increased 26.1% (P<.001) over the study period: 18.6% from 2006 to 2007 (P<.001), 4.3% from 2007 to 2008 (P=.46), 1.8% from 2008 to 2009 (P=.73), and 0.13% from 2009 to 2010 (P=.95). Emergency department visits occurred more frequently with individuals 85 years or older (relative risk [RR], 13.74; P<.001), females (RR, 1.77; P<.001) and in the northeast United States (RR, 1.42; P<.001). From 2009 to 2010, the mortality rate decreased 17.9% (P=.01).
The prevalence of CDI presenting to EDs increased each year from 2006 to 2010; however, the rate of increase slowed from each year to the next. The mortality rate increased from 2006 to 2009 and decreased significantly from 2009 to 2010. C difficile infection visits presenting to EDs occurred more frequently with older individuals, females, and in the northeast.
本研究的目的是确定美国急诊科艰难梭菌感染（CDI）的患病率。次要目标包括确定CDI的负担。
这是一项对29个州980家美国医院急诊科2006 - 2010年全国急诊科样本数据库的回顾性观察队列研究。测量了患病率、死亡率、住院时间、住院费用和地方性。
共识别出474513例与CDI相关的急诊科就诊患者。2006年至2010年，CDI的患病率从每10万人26.2例增至33.1例（P<0.001）。在研究期间，与CDI相关的急诊科病例数增加了26.1%（P<0.001）：2006年至2007年增加了18.6%（P<0.001），2007年至2008年增加了4.3%（P = 0.46），2008年至2009年增加了1.8%（P = 0.73），2009年至2010年增加了0.13%（P = 0.95）。85岁及以上的个体（相对风险[RR]，13.74；P<0.001）、女性（RR，1.77；P<0.001）以及美国东北部地区（RR，1.42；P<0.001）的急诊科就诊更为频繁。2009年至2010年，死亡率下降了17.9%（P = 0.01）。
2006年至2010年，急诊科CDI的患病率逐年上升；然而，增长速度逐年放缓。死亡率在2006年至2009年上升，在2009年至2010年显著下降。急诊科CDI就诊在老年人、女性以及东北部地区更为频繁。
