Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 3912 Taubman Center, 1500 E. Medical Center Dr., SPC, Ann Arbor, MI, 5362, USA.
Division of Gastroenterology, University of South Carolina School of Medicine, Columbia, SC, USA.
Obes Surg. 2021 May;31(5):2168-2173. doi: 10.1007/s11695-021-05245-9. Epub 2021 Feb 5.
Readmission for patients hospitalized with Clostridioides difficile infections (CDIs) carries high morbidity, mortality, and burden on healthcare resources. This study aims to determine if morbid obesity is risk factor for 30-day readmission in patients hospitalized with CDI.
This retrospective cohort study used the 2014 National Readmission Database. Included patients had a principal diagnosis of CDI and excluded if younger than 18 years of age or admitted during the month of December. Readmissions to any hospital for non-trauma diagnoses within 30 days of the index admission were included. The primary outcome was 30-day all cause readmission. Secondary outcomes were (1) in-hospital mortality; (2) morbidity, initiation of dialysis, or total parenteral nutrition; and (3) resource utilization during index admissions.
A total of 91,265 subjects were included in this study, 4388 of whom were morbidly obese. Morbid obesity was associated with significantly higher odds of readmission and was associated with higher adjusted mean total hospitalization charges and costs, higher odds of PMV, and acute renal failure requiring dialysis in individuals that develop CDI.
Morbid obesity is an independent risk factor for 30-day readmission in patients hospitalized for CDI. Morbidly obese patients admitted for CDI experienced higher morbidity and increased resource utilization.
患有艰难梭菌感染（CDI）住院的患者再次入院会带来较高的发病率、死亡率和医疗资源负担。本研究旨在确定病态肥胖是否是 CDI 住院患者 30 天内再次入院的危险因素。
这是一项回顾性队列研究，使用了 2014 年国家再入院数据库。纳入的患者有 CDI 的主要诊断，排除了年龄小于 18 岁或在 12 月入院的患者。将索引入院后 30 天内因非创伤性诊断再次入院的患者纳入。主要结局是 30 天全因再入院。次要结局是（1）住院期间死亡率；（2）发病率、开始透析或全胃肠外营养；以及（3）索引入院期间的资源利用。
本研究共纳入 91265 名患者，其中 4388 名患者为病态肥胖。病态肥胖与再入院的可能性显著增加相关，与调整后的平均总住院费用和成本增加、机械通气的可能性增加以及因 CDI 发展而需要透析的急性肾衰竭相关。
病态肥胖是 CDI 住院患者 30 天内再次入院的独立危险因素。因 CDI 入院的病态肥胖患者发病率更高，资源利用率增加。
