A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissionsReport as inadecuate




A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions - Download this document for free, or read online. Document in PDF available to download.

Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection CDI. We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data emergency department visits and hospital admissions in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011. We evaluated all-cause mortality and costs unadjusted and adjusted for survival from the healthcare payer perspective 2014 Canadian dollars. During our study period, we identified 7,950 infected subjects. The mean age was 63.5 years standard deviation = 22.0, 62.7% were female, and 45.0% were very high users of the healthcare system. The relative risk for 30-day, 180-day, and 1-year mortality were 7.32 95% confidence interval CI, 5.94–9.02, 3.55 95%CI, 3.17–3.97, and 2.59 95%CI, 2.37–2.83, respectively. Mean attributable cumulative 30-day, 180-day, and 1-year costs unadjusted for survival were $7,434 95%CI, $7,122-$7,762, $12,517 95%CI, $11,687-$13,366, and $13,217 95%CI, $12,062-$14,388. Mean attributable cumulative 1-, 2-, and 3-year costs adjusted for survival were $10,700 95%CI, $9,811-$11,645, $13,312 95%CI, $12,024-$14,682, and $15,812 95%CI, $14,159-$17,571. Infected subjects had considerably higher risk of all-cause mortality and costs compared with uninfected subjects. This study provides insight on an understudied patient group. Our study findings will facilitate assessment of interventions to prevent community-onset CDI.



Author: Natasha Nanwa , Beate Sander, Murray Krahn, Nick Daneman, Hong Lu, Peter C. Austin, Anand Govindarajan, Laura C. Rosella, Suzanne

Source: http://plos.srce.hr/



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