Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients: a prospective cohort study
Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients: a prospective cohort study
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DOI：
10.1016/j.jhin.2016.04.004
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发表时间：
2016-07-01
影响因子：
6.9
通讯作者：
Garey, K. W.
中科院分区：
文献类型：
--
作者：
Shah, D. N.;Aitken, S. L.;Garey, K. W.
背景：很少有研究调查复发性艰难梭菌感染 (CDI) 的额外医疗费用。目的：与经历复发性 CDI 的 CDI 患者相比，量化仅患有原发性 CDI 的住院患者的 CDI 住院治疗费用和住院时间。方法：这是一项前瞻性、观察性队列研究，对住院的原发性 CDI 成人患者进行为期三个月的随访，以评估复发性 CDI 发作。对经历或未经历至少一次复发性 CDI 发作的患者的总住院时间 (LOS) 和住院费用进行比较。结果：总共纳入了 540 名年龄 62 +/- 17 岁的原发性 CDI 住院患者（42% 男性），其中 95 名患者 (18%) 经历了 101 次复发性 CDI 发作。仅原发性 CDI 患者的 CDI 归因中位数（四分位距）LOS 和费用（单位：美元）从 7 (4-13) 天增加到 13,168 美元 (7,525-24,456)，而复发性 CDI 患者则从 15 (8-25) 天增加到 28,218 美元 (15,050-47,030) (P < 0.0001，每个）。仅原发性 CDI 患者的总医院中位 LOS 和费用从 11 (6-22) 天和 20,693 美元 (11,287-41,386) 增加，而复发性 CDI 患者则为 24 (11-48) 天和 45,148 美元 (20,693-82,772)（P < 0.0001）。仅原发性 CDI 患者 (N = 445) 住院期间药物治疗的中位费用为 60 美元 (23-200)，复发性 CDI 患者 (P = 0.0013) 为 140 美元 (30-260)。结论：本研究表明，CDI 患者承受着因 CDI 造成的重大医疗保健经济负担。复发性 CDI 患者的经济成本和医疗负担显着增加。 (C) 2016 年医疗保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Few studies have investigated the additional healthcare costs of recurrent C. difficile infection (CDI).Aim: To quantify inpatient treatment costs for CDI and length of stay among hospitalized patients with primary CDI only, compared with CDI patients who experienced recurrent CDI.Methods: This was a prospective, observational cohort study of hospitalized adult patients with primary CDI followed for three months to assess for recurrent CDI episodes. Total and CDI-attributable hospital length of stay (LOS) and hospitalization costs were compared among patients who did or did not experience at least one recurrent CDI episode.Findings: In all, 540 hospitalized patients aged 62 +/- 17 years (42% males) with primary CDI were enrolled, of whom 95 patients (18%) experienced 101 recurrent CDI episodes. CDI-attributable median (interquartile range) LOS and costs (in US$) increased from 7 (4-13) days and $ 13,168 (7,525-24,456) for patients with primary CDI only versus 15 (8-25) days and $ 28,218 (15,050-47,030) for patients with recurrent CDI (P < 0.0001, each). Total hospital median LOS and costs increased from 11 (6-22) days and $ 20,693 (11,287-41,386) for patients with primary CDI only versus 24 (11-48) days and $ 45,148 (20,693-82,772) for patients with recurrent CDI (P < 0.0001, each). The median cost of pharmacological treatment while hospitalized was $ 60 (23-200) for patients with primary CDI only (N = 445) and $ 140 (30-260) for patients with recurrent CDI (P = 0.0013).Conclusion: This study demonstrated that patients with CDI experience a significant healthcare economic burden attributed to CDI. Economic costs and healthcare burden increased significantly for patients with recurrent CDI. (C) 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.