艰难梭菌感染住院的医疗后果：一项倾向评分匹配研究。
Health care consequences of hospitalization with Clostrioides difficile infection: a propensity score matching study.
机构信息
Division of Infectious Disease, Northwell Health, Manhasset, NY, 11030, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
出版信息
BMC Infect Dis. 2022 Jul 15;22(1):620. doi: 10.1186/s12879-022-07594-x.
BACKGROUND
Clostridiodies difficile infection (CDI) has been characterized by the Center for Disease Control and Prevention (CDC) as an urgent public health threat and a major concern in hospital, outpatient and extended-care facilities worldwide.
METHODS
A retrospective cohort study of patients aged ≥ 18 hospitalized with CDI in New York State (NYS) between January 1, 2014-December 31, 2016. Data were extracted from NY Statewide Planning and Research Cooperative (SPARCS) and propensity score matching was performed to achieve comparability of the CDI (exposure) and non-CDI (non-exposure) groups. Of the 3,714,486 hospitalizations, 28,874 incidence CDI cases were successfully matched to 28,874 non-exposures.
RESULTS
The matched pairs comparison demonstrated that CDI cases were more likely to be readmitted to the hospital at 30 (28.26% vs. 19.46%), 60 (37.65% vs. 26.02%), 90 (42.93% vs. 30.43) and 120 days (46.47% vs. 33.74), had greater mortality rates at 7 (3.68% vs. 2.0%) and 180 days (20.54% vs. 11.96%), with significant increases in length of stay and total hospital charges (p < .001, respectively).
CONCLUSIONS
CDI is associated with a large burden on patients and health care systems, significantly increasing hospital utilization, costs and mortality.
背景
疾病控制与预防中心（CDC）将艰难梭菌感染（CDI）定义为一种紧急的公共卫生威胁，也是全球医院、门诊和长期护理机构的主要关注点。
方法
这是一项回顾性队列研究，纳入了 2014 年 1 月 1 日至 2016 年 12 月 31 日期间在纽约州（NYS）住院治疗 CDI 的年龄≥18 岁的患者。数据来自 NYS 全州规划和研究合作组织（SPARCS），采用倾向评分匹配来实现 CDI（暴露）和非 CDI（非暴露）组的可比性。在 3714486 例住院患者中，成功匹配了 28874 例 CDI 发生率病例和 28874 例非暴露病例。
结果
匹配对比较表明，CDI 病例在 30 天（28.26% vs. 19.46%）、60 天（37.65% vs. 26.02%）、90 天（42.93% vs. 30.43%）和 120 天（46.47% vs. 33.74%）时更有可能再次住院，7 天（3.68% vs. 2.0%）和 180 天（20.54% vs. 11.96%）时死亡率更高，且住院时间和总住院费用显著增加（均 p<0.001）。
结论
CDI 给患者和医疗系统带来了巨大负担，显著增加了医院的利用率、成本和死亡率。
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