Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis
Abstract Objective: To describe 12-month outcomes for beneficiaries in the 100% Medicare Fee-for-Service (FFS) population with primary and recurrent Clostridioides difficile infection (CDI). Design: A retrospective, descriptive, cohort study of CDI claims from the 100% Medicare FFS population, w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X2200002X/type/journal_article |
| _version_ | 1811157168800399360 |
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| author | Paul Feuerstadt Winnie W. Nelson Christie Teigland David N. Dahdal |
| author_facet | Paul Feuerstadt Winnie W. Nelson Christie Teigland David N. Dahdal |
| author_sort | Paul Feuerstadt |
| collection | DOAJ |
| description |
Abstract
Objective:
To describe 12-month outcomes for beneficiaries in the 100% Medicare Fee-for-Service (FFS) population with primary and recurrent Clostridioides difficile infection (CDI).
Design:
A retrospective, descriptive, cohort study of CDI claims from the 100% Medicare FFS population, with a first CDI diagnosis between January 1, 2010, and December 31, 2016.
Setting:
Any US-based provider that submitted inpatient or outpatient CDI diagnosis claims to Medicare FFS.
Patients:
The study included patients aged ≥65 years with continuous enrollment in Medicare Parts A, B, and D during 12 months before and 12 months after the index period.
Methods:
The number of CDI and recurrent (rCDI) episodes, healthcare resource utilization, treatments, complications, and procedures were calculated for pre-index and follow-up periods. The data were stratified by number of rCDI episodes (ie, no rCDI, 1 rCDI, 2 rCDI, and ≥3 rCDI).
Results:
Of 268,762 patients with an index CDI, 34.7% had at least 1 recurrence. Of those who had 1 recurrence, 59.1% had a second recurrence and of those who had 2 recurrences, 58.4% had ≥3 recurrences. Incident psychiatric conditions occurred in 11.3%–18.2% of each rCDI cohort; 6.0% of patients with rCDI underwent subtotal colectomy, and 1.1% of patients underwent diverting loop ileostomy. After each CDI episode, ∼1 in 5 patients had a documented sepsis event. Over the 12-month follow-up, 30% of patients experienced sepsis, and sepsis occurred in 27.0% of the cohort with no rCDI, compared to 35.5% of patients in the rCDI cohorts.
Conclusions:
Elderly patients with CDI and rCDI experienced a significant clinical burden and complications.
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| first_indexed | 2024-04-10T05:02:35Z |
| format | Article |
| id | doaj.art-7c534459ca2645138cb7335e7ac19740 |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-04-10T05:02:35Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-7c534459ca2645138cb7335e7ac197402023-03-09T12:28:17ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2022-01-01210.1017/ash.2022.2Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysisPaul Feuerstadt0Winnie W. Nelson1https://orcid.org/0000-0003-0013-3199Christie Teigland2https://orcid.org/0000-0003-4887-8077David N. Dahdal3https://orcid.org/0000-0003-0657-6839Gastroenterology Center of Connecticut, Hamden, Connecticut Division of Gastroenterology, Yale University School of Medicine, New Haven, ConnecticutFerring Pharmaceuticals, Parsippany, New JerseyAvalere Health, Washington, DCFerring Pharmaceuticals, Parsippany, New Jersey Abstract Objective: To describe 12-month outcomes for beneficiaries in the 100% Medicare Fee-for-Service (FFS) population with primary and recurrent Clostridioides difficile infection (CDI). Design: A retrospective, descriptive, cohort study of CDI claims from the 100% Medicare FFS population, with a first CDI diagnosis between January 1, 2010, and December 31, 2016. Setting: Any US-based provider that submitted inpatient or outpatient CDI diagnosis claims to Medicare FFS. Patients: The study included patients aged ≥65 years with continuous enrollment in Medicare Parts A, B, and D during 12 months before and 12 months after the index period. Methods: The number of CDI and recurrent (rCDI) episodes, healthcare resource utilization, treatments, complications, and procedures were calculated for pre-index and follow-up periods. The data were stratified by number of rCDI episodes (ie, no rCDI, 1 rCDI, 2 rCDI, and ≥3 rCDI). Results: Of 268,762 patients with an index CDI, 34.7% had at least 1 recurrence. Of those who had 1 recurrence, 59.1% had a second recurrence and of those who had 2 recurrences, 58.4% had ≥3 recurrences. Incident psychiatric conditions occurred in 11.3%–18.2% of each rCDI cohort; 6.0% of patients with rCDI underwent subtotal colectomy, and 1.1% of patients underwent diverting loop ileostomy. After each CDI episode, ∼1 in 5 patients had a documented sepsis event. Over the 12-month follow-up, 30% of patients experienced sepsis, and sepsis occurred in 27.0% of the cohort with no rCDI, compared to 35.5% of patients in the rCDI cohorts. Conclusions: Elderly patients with CDI and rCDI experienced a significant clinical burden and complications. https://www.cambridge.org/core/product/identifier/S2732494X2200002X/type/journal_article |
| spellingShingle | Paul Feuerstadt Winnie W. Nelson Christie Teigland David N. Dahdal Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis |
| title_full | Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis |
| title_fullStr | Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis |
| title_full_unstemmed | Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis |
| title_short | Clinical burden of recurrent Clostridioides difficile infection in the medicare population: A real-world claims analysis |
| title_sort | clinical burden of recurrent clostridioides difficile infection in the medicare population a real world claims analysis |
| url | https://www.cambridge.org/core/product/identifier/S2732494X2200002X/type/journal_article |
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