Health Care Costs and Mortality Associated with Nosocomial Diarrhea Due to Clostridium difficile

TLDR

The study aimed to determine whether patients whose hospital stay is complicated by Clostridium difficile–associated diarrhea experience differences in cost, length of stay, and survival rates compared with patients without such complications. A prospective cohort of 271 patients was followed to assess these outcomes. Forty patients (15%) developed CDI, which was associated with a 54 % increase in adjusted hospital costs ($3,669 more), an additional 3.6 days of stay, no excess 3‑month or 1‑year mortality, and the study estimates the annual national cost exceeds $1.1 billion.

Abstract

A total of 271 patients were prospectively followed up to determine whether patients whose hospital stay is complicated by diarrhea due to Clostridium difficile experience differences in cost and length of stay and survival rates when compared with patients whose stay is not complicated by C. difficile–associated diarrhea. Forty patients (15%) developed nosocomial C. difficile–associated diarrhea. These patients incurred adjusted hospital costs of $3669—that is, 54% (95% confidence interval [CI], 17%–103%)—higher than patients whose course was not complicated by C. difficile–associated diarrhea. The extra length of stay attributable to C. difficile–associated diarrhea was 3.6 days (95% CI, 1.5–6.2). C. difficile–associated diarrhea was not associated with excess 3-month or 1-year mortality after adjustment for age, comorbidity, and disease severity. On the basis of the findings of this study, a conservative estimate of the cost of this disease in the United States exceeds $1.1 billion per year.