Yang Tsu Jung, Patel Achint A, Singh Jassimran, Jahagirdar Vinay, Solanki Dhanshree, Nikhare Bharati, Harwani Nishi, Goswami Ruchir, Devani Hiteshkumar, Maiyani Prakash, Moradiya Dharmeshkumar V, Desai Maheshkumar, Muddassir Salman
Medicine, MultiCare Good Samaritan Hospital, Puyallup, USA.
Internal Medicine, HCA Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Oak Hill Hospital, Brooksville, USA.
Cureus. 2022 Sep 23;14(9):e29497. doi: 10.7759/cureus.29497. eCollection 2022 Sep.
Background infection (CDI) is one of the rising public health threats in the United States. It has imposed significant morbidity and mortality in the elderly population. However, the burden of the disease in the young population is unclear. This study aimed to identify hospitalization trends and outcomes of CDI in the young population. Methodology We obtained data from the National (Nationwide) Inpatient Sample (NIS) for hospitalizations with CDI between 2007 and 2017. We used the International Classification of Diseases Ninth Edition-Clinical Modification (ICD-9-CM) and ICD-10-CM to identify CDI and other diagnoses of interest. The primary outcome of our study was to identify the temporal trends and demographic characteristics of patients aged less than 50 years old hospitalized with CDI. The secondary outcomes were in-hospital mortality, length of hospital stay (LOS), and discharge dispositions. We utilized the Cochran Armitage trend test and multivariable survey logistic regression models to analyze the trends and outcomes. Results From 2007 to 2017, CDI was present among 1,158,047 hospitalized patients. The majority (84.04%) of the patients were ≥50 years old versus 15.95% of patients <50 years old. From 2007 to 2017, there was a significant increase in CDI among <50-year-old hospitalized patients (12.6% from 2007 to 18.1% in 2017; p < 0.001). In trend analysis by ethnicities, among patients <50 years old, there was an increasing trend in Caucasians (63.9% versus 67.9%; p < 0.001) and Asian females (58.4% versus 62.6%; p < 0.001). We observed an increased trend of discharge to home (91.3% vs 95.8%; p < 0.001) in association with a decrease in discharge to facility (8.3% vs 4%; p < 0.001). The average LOS from 2007 to 2017 was 5 ± 0.03 days, which remained stable during the study period. Conclusions The proportion of young (<50 years old) hospitalized patients with CDI has been steadily increasing over the past decade. Our findings might represent new epidemiological trends related to non-traditional risk factors. Future CDI surveillance should extend to the young population to confirm our findings, and the study of emerging risk factors is required to better understand the increasing CDI hospitalization in the young population.
背景 艰难梭菌感染（CDI）是美国日益严重的公共卫生威胁之一。它给老年人群带来了显著的发病率和死亡率。然而，该疾病在年轻人群中的负担尚不清楚。本研究旨在确定年轻人群中CDI的住院趋势和结局。方法 我们从国家（全国）住院患者样本（NIS）中获取了2007年至2017年因CDI住院的数据。我们使用国际疾病分类第九版临床修订本（ICD - 9 - CM）和ICD - 10 - CM来确定CDI及其他感兴趣的诊断。我们研究的主要结局是确定年龄小于50岁因CDI住院患者的时间趋势和人口统计学特征。次要结局包括住院死亡率、住院时间（LOS）和出院处置情况。我们利用 Cochr an Armitage趋势检验和多变量调查逻辑回归模型来分析趋势和结局。结果 2007年至2017年期间，1,158,047名住院患者中存在CDI。大多数（84.04%）患者年龄≥50岁，而年龄<50岁的患者占15.95%。2007年至2017年期间，年龄<50岁的住院患者中CDI显著增加（从2007年的12.6%增至2017年的18.1%；p < 0.001）。在按种族进行的趋势分析中，年龄<50岁的患者中，白种人（从63.9%增至67.9%；p < 0.001）和亚洲女性（从58.4%增至62.6%；p < 0.001）呈上升趋势。我们观察到出院回家的趋势增加（从91.3%增至95.8%；p < 0.001），同时转至医疗机构的出院比例下降（从8.3%降至4%；p < 0.001）。2007年至2017年的平均住院时间为5 ± 0.03天，在研究期间保持稳定。结论 在过去十年中，年龄<50岁因CDI住院的患者比例一直在稳步增加。我们的发现可能代表了与非传统风险因素相关的新的流行病学趋势。未来CDI监测应扩展到年轻人群以证实我们的发现，并且需要对新出现的风险因素进行研究，以更好地理解年轻人群中CDI住院增加的情况。
