Chen Yingxi, Glass Kathryn, Liu Bette, Korda Rosemary J, Riley Thomas V, Kirk Martyn D
Research School of Population Health, Australian National University, Canberra, Australia.
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Am J Infect Control. 2017 May 1;45(5):508-511. doi: 10.1016/j.ajic.2016.12.006. Epub 2017 Jan 13.
Clostridium difficile is the principal cause of infectious diarrhea in hospitalized patients. The aim of this study was to describe and compare length of stay (LOS), costs, and in-hospital deaths for C difficile infection (CDI) and non-CDI hospitalizations, in a cohort of middle-aged and older Australians.
We used survey data from the 45 and Up Study, linked to hospitalization and death data. We calculated the average LOS and costs per hospitalization, and the proportion of in-hospital deaths for CDI and non-CDI hospitalizations. We then compared hospitalizations with CDI as a secondary diagnosis to non-CDI hospitalizations by stratifying hospitalizations based on principal diagnosis and then using generalized linear models to compare LOS and in-hospital costs, and logistic regression for in-hospital deaths, adjusting for age and sex.
There were 641 CDI hospitalizations during 2006-2012. The average LOS was 17 days; the average cost per hospitalization was AUD 12,704; and in 7.3% of admissions (47 out of 641) the patient died. After adjusting for age and sex, hospitalizations with CDI were associated with longer LOS, higher costs, and a greater proportion of in-hospital deaths compared with hospitalizations with similar principal diagnosis but without CDI.
CDI places additional burden on the Australian hospital system, with CDI patients having relatively lengthy hospital stays and high costs.
艰难梭菌是住院患者感染性腹泻的主要病因。本研究旨在描述和比较澳大利亚中年及老年人群队列中，艰难梭菌感染（CDI）住院和非CDI住院的住院时长、费用及院内死亡情况。
我们使用了来自“45岁及以上研究”的调查数据，并将其与住院和死亡数据相链接。我们计算了每次住院的平均住院时长和费用，以及CDI住院和非CDI住院的院内死亡比例。然后，我们通过根据主要诊断对住院进行分层，将CDI作为次要诊断的住院与非CDI住院进行比较，接着使用广义线性模型比较住院时长和院内费用，并使用逻辑回归分析院内死亡情况，同时对年龄和性别进行了调整。
2006年至2012年期间共有641例CDI住院病例。平均住院时长为17天；每次住院的平均费用为12,704澳元；7.3%的入院病例（641例中的47例）患者死亡。在对年龄和性别进行调整后，与主要诊断相似但无CDI的住院相比，CDI住院的住院时长更长、费用更高，且院内死亡比例更大。
CDI给澳大利亚医院系统带来了额外负担，CDI患者的住院时间相对较长且费用较高。
