Increase in Adult Clostridium difficile–related Hospitalizations and Case-Fatality Rate, United States, 2000–2005
2008

Increase in Adult Clostridium difficile Hospitalizations

Sample size: 160000 publication 10 minutes Evidence: high

Author Information

Author(s): Zilberberg Marya D., Shorr Andrew F., Kollef Marin H.

Primary Institution: University of Massachusetts, Amherst

Hypothesis

The increase in CDAD-related deaths is at least partially due to a rise in hospitalizations with this disease.

Conclusion

There was a 23% annual increase in CDAD hospitalizations from 2000 to 2005, with the case-fatality rate nearly doubling during this period.

Supporting Evidence

  • The incidence of adult CDAD hospitalizations doubled from 5.5 cases per 10,000 in 2000 to 11.2 in 2005.
  • The age-adjusted case-fatality rate rose from 1.2% in 2000 to 2.2% in 2004.
  • 80% of all CDAD-related deaths occur in acute-care hospitals.
  • Overall hospitalizations rose approximately 1.3% annually during the same period.
  • The rate of increase in the incidence of CDAD was steepest in the >85 age group.

Takeaway

More adults are getting sick from a germ called Clostridium difficile, and many are ending up in the hospital. This is making it more dangerous and leading to more deaths.

Methodology

A population-based analysis of CDAD-related adult hospitalizations was conducted using National Inpatient Sample data from 2000 to 2005.

Potential Biases

The administrative nature of the data may lead to misclassification of cases.

Limitations

The analysis relied on ICD-9-CM coding, which may have predisposed case ascertainment to misclassification.

Participant Demographics

The study focused on adult hospitalizations, with significant increases noted across various age groups.

Statistical Information

P-Value

0.001

Confidence Interval

95% CI 7.6–14.9

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3201/eid1406.071447

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