Abdalla Abubaker O, Narala Sai B, Abdallah Mohamed A, Doshi Rajkumar, Gullapalli Nageshwara
Mayo Clinic, Hospital Internal Medicine, Rochester, MN, USA.
School of Medicine, University of Nevada, Reno, NV, USA.
Scand J Gastroenterol. 2019 Nov;54(11):1353-1356. doi: 10.1080/00365521.2019.1683223. Epub 2019 Oct 30.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections. It contributes to significant morbidity and mortality among hospitalized patients in the United States. Prior studies suggest worse outcomes of CDI in patients with diverticulitis and increased risk for recurrent CDI. We conducted this study to evaluate the outcomes of CDI in patients with diverticular disease from a nationwide data sample (2012-2015). The National Inpatient Sample (NIS) database between January 2012 and September 2015 was queried for CDI admissions using the International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] codes 008.45, 562.11, 562.10, 562.12, and 562.13 for diagnoses of CDI and diverticular disease. The study included 1,327,595 patients who were admitted between 2012 and 2105 for CDI. Out of all of the patients, 84,170 (6.34%) had a concurrent diagnosis of diverticular disease. After adjusting for confounding variables, the in-hospital mortality was lower [odd ratio (OR): 0.48, 95% CI: 0.44-0.52, < .001] for patients with diverticular disease. The length of stay (LOS) was longer [10.5 versus 9.3 days, < .001] and mean cost of hospitalization was significantly higher in patients without a history of diverticular disease. In a nationwide population study, admissions with CDI, patients with a concurrent diagnosis of diverticular disease had lower in-hospital mortality. The observed results are different from prior studies and might be attributed to a higher burden of normal flora in those patients and increased use of antibiotic stewardship program across many hospitals nationwide.
艰难梭菌感染（CDI）是最常见的医疗相关感染之一。它在美国住院患者中导致了显著的发病率和死亡率。先前的研究表明，憩室炎患者的CDI预后较差，且复发性CDI的风险增加。我们进行这项研究以评估来自全国数据样本（2012 - 2015年）的憩室病患者的CDI预后。利用国际疾病分类第九版临床修订本（ICD - 9 - CM）编码008.45、562.11、562.10、562.12和562.13，对2012年1月至2015年9月期间的国家住院患者样本（NIS）数据库进行查询，以获取CDI入院病例，用于诊断CDI和憩室病。该研究纳入了2012年至2015年因CDI入院的1,327,595名患者。在所有患者中，84,170名（6.34%）同时诊断为憩室病。在调整混杂变量后，憩室病患者的住院死亡率较低[比值比（OR）：0.48，95%置信区间：0.44 - 0.52，P <.001]。住院时间（LOS）更长[10.5天对9.3天，P <.001]，且无憩室病病史患者的平均住院费用显著更高。在一项全国性人群研究中，患有CDI且同时诊断为憩室病的患者住院死亡率较低。观察到的结果与先前的研究不同，这可能归因于这些患者中正常菌群的负担较重以及全国许多医院对抗生素管理计划的使用增加。
