C. diff Rates Rising, AHRQ Reports
The Healthcare Cost and Utilization Project (H-CUP), an entity of the Agency for Healthcare Research and Quality, just released data detailing the rates of clostridium difficile-associated disease (pdf) (CDAD) in the U.S. from 1993 to 2005. CDAD is generally categorized as being a healthcare-associated infection (HAI).
Between 2001 and 2005, the number of patients discharged with CDAD more than doubled. This increase was significantly higher than the increase seen during the eight year period prior. During that time period, cases increased by almost three quarters.
Of the areas across the country, the Northeast had the highest incidence of infection. The rate in that area was 144 cases of CDAD for every 100,000 patients. This rate was twice that observed in the West, the area of the country with the lowest incidence of CDAD. The South was 42 percent higher than the West and the Midwest was 69 percent higher than West.
In every respect, patients with CDAD were sicker than other inpatients without this condition. On average, these patients spent three times longer in the hospital than the average patient stay. Moreover, the mortality rate among these patients was 4.5 times higher than the average mortality rate in the U.S.
Importantly, the majority of patients with CDAD are elderly. Over 66 percent of patients with the condition noted in the H-CUP data are 65 years and older.
To treat CDAD, less than 0.5 percent of all the patients underwent subtotal colectomy. Those patients had bowel perforation and peritonitis secondary to fulminant CDAD. In 2005, approximately 1,100 patients underwent this procedure.
The report assessed rates of CDAD through assessment of ICD-9 codes. This approach to complete surveillance rates has high rates of both sensitivity and specificity. Importantly, rates of infection do not indicate where the infection originated, in the hospital or the community. The goal of the report was to document the rate of infections within the inpatient setting.
April 28, 2008 Related topics: Hygiene & Cleanliness