Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study
(1) Background: <i>Clostridioides difficile</i> infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/11/5/555 |
| _version_ | 1827667446637527040 |
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| author | Gregorio Benitez Fadi Shehadeh Markos Kalligeros Evangelia K. Mylona Quynh-Lam Tran Ioannis M. Zacharioudakis Eleftherios Mylonakis |
| author_facet | Gregorio Benitez Fadi Shehadeh Markos Kalligeros Evangelia K. Mylona Quynh-Lam Tran Ioannis M. Zacharioudakis Eleftherios Mylonakis |
| author_sort | Gregorio Benitez |
| collection | DOAJ |
| description | (1) Background: <i>Clostridioides difficile</i> infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an index hospital stay for CDI. (2) Methods: We analyzed the electronic medical data of admitted patients in our health system over a two-year period. A multivariate logistic regression model, supplemented with bias-corrected and accelerated confidence intervals (BCa-CI), was implemented to assess the risk factors. (3) Results: A total of 1253 adult CDI index cases were included in the analysis. The readmission rate for CDI within 90 days of discharge was 11% (140/1253). The risk factors for CDI-related readmission were fluoroquinolone exposure within 90 days before the day of index CDI diagnosis (aOR: 1.58, 95% CI: 1.05–2.37), higher Elixhauser comorbidity score (aOR: 1.05, 95% CI: 1.02–1.07), and being discharged home (aOR: 1.64, 95% CI: 1.06–2.54). In contrast, a longer length of index stay (aOR: 0.97, 95% BCa-CI: 0.95–0.99) was associated with reduced odds of readmission for CDI. (4) Conclusion: More than 1 out of 10 patients were readmitted for CDI following an index hospital stay for CDI. Patients with recent previous fluoroquinolone exposure, greater overall comorbidity burden, and those discharged home are at higher risk of readmission for CDI. |
| first_indexed | 2024-03-10T03:11:48Z |
| format | Article |
| id | doaj.art-be8503ff77ec4fb48bb946844f1003f9 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T03:11:48Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-be8503ff77ec4fb48bb946844f1003f92023-11-23T12:32:30ZengMDPI AGPathogens2076-08172022-05-0111555510.3390/pathogens11050555Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort StudyGregorio Benitez0Fadi Shehadeh1Markos Kalligeros2Evangelia K. Mylona3Quynh-Lam Tran4Ioannis M. Zacharioudakis5Eleftherios Mylonakis6Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAInfectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAInfectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAInfectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAInfectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USADivision of Infectious Diseases and Immunology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USAInfectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA(1) Background: <i>Clostridioides difficile</i> infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an index hospital stay for CDI. (2) Methods: We analyzed the electronic medical data of admitted patients in our health system over a two-year period. A multivariate logistic regression model, supplemented with bias-corrected and accelerated confidence intervals (BCa-CI), was implemented to assess the risk factors. (3) Results: A total of 1253 adult CDI index cases were included in the analysis. The readmission rate for CDI within 90 days of discharge was 11% (140/1253). The risk factors for CDI-related readmission were fluoroquinolone exposure within 90 days before the day of index CDI diagnosis (aOR: 1.58, 95% CI: 1.05–2.37), higher Elixhauser comorbidity score (aOR: 1.05, 95% CI: 1.02–1.07), and being discharged home (aOR: 1.64, 95% CI: 1.06–2.54). In contrast, a longer length of index stay (aOR: 0.97, 95% BCa-CI: 0.95–0.99) was associated with reduced odds of readmission for CDI. (4) Conclusion: More than 1 out of 10 patients were readmitted for CDI following an index hospital stay for CDI. Patients with recent previous fluoroquinolone exposure, greater overall comorbidity burden, and those discharged home are at higher risk of readmission for CDI.https://www.mdpi.com/2076-0817/11/5/555<i>Clostridioides difficile</i>risk factorsreadmissionfluoroquinolonecomorbiditydischarge |
| spellingShingle | Gregorio Benitez Fadi Shehadeh Markos Kalligeros Evangelia K. Mylona Quynh-Lam Tran Ioannis M. Zacharioudakis Eleftherios Mylonakis Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study Pathogens <i>Clostridioides difficile</i> risk factors readmission fluoroquinolone comorbidity discharge |
| title | Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study |
| title_full | Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study |
| title_fullStr | Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study |
| title_full_unstemmed | Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study |
| title_short | Risk Factors for Hospital Readmission for <i>Clostridioides difficile</i> Infection: A Statewide Retrospective Cohort Study |
| title_sort | risk factors for hospital readmission for i clostridioides difficile i infection a statewide retrospective cohort study |
| topic | <i>Clostridioides difficile</i> risk factors readmission fluoroquinolone comorbidity discharge |
| url | https://www.mdpi.com/2076-0817/11/5/555 |
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