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WASHINGTON — Nosocomial Clostridium difficile infection was associated with 85% higher costs per hospital stay and 99% longer lengths of stay in the first-ever nationwide multihospital analysis of these infections.
The study included 10,857 cases of C. difficile infection (CDI) and 19,214 controls; all were adult inpatients. Data were collected from teaching hospitals in the University HealthSystem Consortium for the period 2002-2007. The number of hospitals participating in the UHC's clinical resource manager database varied from 25 to 45, depending on the year.
Cases of health care-acquired CDI were defined as instances where patients had the appropriate ICD-9 code listed as a secondary diagnosis, and metronidazole or oral vancomycin was administered for 4 or more days starting on day 5 of the hospitalization or later.
This case definition has been validated, Amy L. Pakyz, Pharm.D., said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the annual meeting of the Infectious Diseases Society of America.
Each case was matched with at least one control who did not have an ICD-9 code for CDI but who had another in the same diagnosis-related group (DRG), was within 5 years of the case patient's age, and was from the same hospital and year quarter.
Both groups had a mean age of 61 years and were 48% female. The CDI group was more likely to be white (68% vs. 65%) and less likely to be black (19% vs. 21%); both were significant differences. The All-Patient Refined DRG severity of illness rating (APR-DRG SOI) for the CDI patients was significantly more likely to be “extreme” (56% vs. 21%) and less likely to be “minor” (2.0% vs. 11%), compared with controls.
Unadjusted mean total hospital costs were $56,407 for the CDI cases vs. $29,237 for controls. Mean length of stay was 21.2 days vs. 10.1 days, respectively. Both differences were highly statistically significant. After adjustment for sex, age, race, and APR-DRG SOI, health care-acquired CDI was associated with 85% higher costs and 99% longer inpatient stays, vs. controls, said Dr. Pakyz of Virginia Commonwealth University, Richmond.
CDI had a greater effect on costs in patients with the “minor” APR-DRG SOI classification, in whom CDI was associated with 65% greater total hospital costs and 46% longer stays, compared with controls.
These results are consistent with those of previous studies done in single hospitals and one multihospital study conducted in Massachusetts, she noted.
Dr. Pakyz received investigator-initiated funding for this study from ViroPharma Inc.
WASHINGTON — Nosocomial Clostridium difficile infection was associated with 85% higher costs per hospital stay and 99% longer lengths of stay in the first-ever nationwide multihospital analysis of these infections.
The study included 10,857 cases of C. difficile infection (CDI) and 19,214 controls; all were adult inpatients. Data were collected from teaching hospitals in the University HealthSystem Consortium for the period 2002-2007. The number of hospitals participating in the UHC's clinical resource manager database varied from 25 to 45, depending on the year.
Cases of health care-acquired CDI were defined as instances where patients had the appropriate ICD-9 code listed as a secondary diagnosis, and metronidazole or oral vancomycin was administered for 4 or more days starting on day 5 of the hospitalization or later.
This case definition has been validated, Amy L. Pakyz, Pharm.D., said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the annual meeting of the Infectious Diseases Society of America.
Each case was matched with at least one control who did not have an ICD-9 code for CDI but who had another in the same diagnosis-related group (DRG), was within 5 years of the case patient's age, and was from the same hospital and year quarter.
Both groups had a mean age of 61 years and were 48% female. The CDI group was more likely to be white (68% vs. 65%) and less likely to be black (19% vs. 21%); both were significant differences. The All-Patient Refined DRG severity of illness rating (APR-DRG SOI) for the CDI patients was significantly more likely to be “extreme” (56% vs. 21%) and less likely to be “minor” (2.0% vs. 11%), compared with controls.
Unadjusted mean total hospital costs were $56,407 for the CDI cases vs. $29,237 for controls. Mean length of stay was 21.2 days vs. 10.1 days, respectively. Both differences were highly statistically significant. After adjustment for sex, age, race, and APR-DRG SOI, health care-acquired CDI was associated with 85% higher costs and 99% longer inpatient stays, vs. controls, said Dr. Pakyz of Virginia Commonwealth University, Richmond.
CDI had a greater effect on costs in patients with the “minor” APR-DRG SOI classification, in whom CDI was associated with 65% greater total hospital costs and 46% longer stays, compared with controls.
These results are consistent with those of previous studies done in single hospitals and one multihospital study conducted in Massachusetts, she noted.
Dr. Pakyz received investigator-initiated funding for this study from ViroPharma Inc.
WASHINGTON — Nosocomial Clostridium difficile infection was associated with 85% higher costs per hospital stay and 99% longer lengths of stay in the first-ever nationwide multihospital analysis of these infections.
The study included 10,857 cases of C. difficile infection (CDI) and 19,214 controls; all were adult inpatients. Data were collected from teaching hospitals in the University HealthSystem Consortium for the period 2002-2007. The number of hospitals participating in the UHC's clinical resource manager database varied from 25 to 45, depending on the year.
Cases of health care-acquired CDI were defined as instances where patients had the appropriate ICD-9 code listed as a secondary diagnosis, and metronidazole or oral vancomycin was administered for 4 or more days starting on day 5 of the hospitalization or later.
This case definition has been validated, Amy L. Pakyz, Pharm.D., said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the annual meeting of the Infectious Diseases Society of America.
Each case was matched with at least one control who did not have an ICD-9 code for CDI but who had another in the same diagnosis-related group (DRG), was within 5 years of the case patient's age, and was from the same hospital and year quarter.
Both groups had a mean age of 61 years and were 48% female. The CDI group was more likely to be white (68% vs. 65%) and less likely to be black (19% vs. 21%); both were significant differences. The All-Patient Refined DRG severity of illness rating (APR-DRG SOI) for the CDI patients was significantly more likely to be “extreme” (56% vs. 21%) and less likely to be “minor” (2.0% vs. 11%), compared with controls.
Unadjusted mean total hospital costs were $56,407 for the CDI cases vs. $29,237 for controls. Mean length of stay was 21.2 days vs. 10.1 days, respectively. Both differences were highly statistically significant. After adjustment for sex, age, race, and APR-DRG SOI, health care-acquired CDI was associated with 85% higher costs and 99% longer inpatient stays, vs. controls, said Dr. Pakyz of Virginia Commonwealth University, Richmond.
CDI had a greater effect on costs in patients with the “minor” APR-DRG SOI classification, in whom CDI was associated with 65% greater total hospital costs and 46% longer stays, compared with controls.
These results are consistent with those of previous studies done in single hospitals and one multihospital study conducted in Massachusetts, she noted.
Dr. Pakyz received investigator-initiated funding for this study from ViroPharma Inc.