Hospital-Acquired Clostridium difficile Blamed for Poor Sepsis Outcomes
New research has found that hospital-onset Clostridium difficile infections increase length of stay (LOS), risk of in-hospital mortality, and hospital costs for inpatients with sepsis.
Authors of a new study titled, “The Impact of Hospital-onset Clostridium difficile Infection on Outcomes of Hospitalized Patients with Sepsis,” report that after multivariate adjustment, in-hospital mortality rate was 24% for patients with sepsis who develop C. diff infections, versus 15% of inpatient controls, according to the paper that was published online in the Journal of Hospital Medicine earlier this month. Adjusted LOS among cases with C. diff was 5.1 days longer than controls (95% confidence interval: 4.4–5.8), and the median-adjusted cost increase was $4,916 (P<0.001).
“Big numbers, but I’m actually not surprised,” says lead author Tara Lagu, MD, MPH, a hospitalist at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass. “I know that it happens, because I see it all the time.”
Dr. Lagu says that when a patient is on day four of five of a stay for sepsis and develops diarrhea, precautions and treatment will last a minimum of three days, which drives up LOS and cost of care.
In the report, Dr. Lagu did not compare the cost-effectiveness of C. diff prevention programs aimed at sepsis patients, but she’s hopeful that is how physicians will use the data.
“I’m just suggesting that if, as a hospital, you’re trying to figure out if your program is worth it, think about these numbers in terms of prevention,” she says. “If it looks like the cost is worth it, then you should keep doing what you’re doing. If not, then maybe you should do something different if you’re not preventing enough cases.”
