Abdalla Abubaker O, Pisipati Sailaja, Elnaggar Mohamed, Rishi Mohit, Doshi Rajkumar, Gullapalli Nageshwara
Department of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Department of Internal Medicine, University of Nevada, School of Medicine, 1155 Mill St W11, Reno, NV 89502, USA.
Gastroenterology Res. 2020 Apr;13(2):53-57. doi: 10.14740/gr1240. Epub 2020 Apr 22.
infection (CDI) is a major health problem that has been on the rise for the last couple of decades. It has significant mortality and morbidity in hospitalized patients. We looked at the outcomes of CDI in patients with liver cirrhosis compared to those without liver cirrhosis.
We conducted a retrospective study from a large inpatient database. The National Inpatient Sample (NIS) was queried for CDI admissions between January 2012 and September 2015. Patients admitted with CDI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The outcomes included overall mortality, length of hospitalization, and healthcare expenditure related to hospitalization.
Out of all patients, 53,765 (3.97%) had concurrent CDI and liver cirrhosis. Diabetes mellitus, alcohol abuse, and acquired immunodeficiency were observed more in patients with liver cirrhosis. Overall mortality (adjusted odds ratio (aOR) 1.65, 95% confidence interval (CI) 1.53 - 1.77, P < 0.001), cost of hospitalization and length of hospital stay (11.0 vs. 10.4 days, P < 0.001) were significantly higher in patients with cirrhosis.
Patients with CDI and liver cirrhosis have significantly higher mortality, prolonged hospitalization and healthcare expenditure. Further studies are recommended to look at reversible risk factors for CDI in patients with liver cirrhosis to guide quality measures that would ultimately improve outcomes.
艰难梭菌感染（CDI）是一个主要的健康问题，在过去几十年中一直在上升。它在住院患者中具有显著的死亡率和发病率。我们比较了肝硬化患者与非肝硬化患者的CDI结局。
我们从一个大型住院患者数据库中进行了一项回顾性研究。查询了2012年1月至2015年9月期间全国住院患者样本（NIS）中的CDI入院情况。使用国际疾病分类第九版临床修订本代码识别CDI入院患者。结局包括总体死亡率、住院时间和与住院相关的医疗费用。
在所有患者中，53765例（3.97%）同时患有CDI和肝硬化。肝硬化患者中糖尿病、酒精滥用和获得性免疫缺陷更为常见。肝硬化患者的总体死亡率（调整优势比（aOR）1.65，95%置信区间（CI）1.53 - 1.77，P < 0.001）、住院费用和住院时间（11.0天对10.4天，P < 0.001）显著更高。
CDI合并肝硬化患者的死亡率显著更高，住院时间延长，医疗费用增加。建议进一步研究肝硬化患者CDI的可逆危险因素，以指导最终改善结局的质量措施。
