CT-606 Predictors and Outcomes of Clostridioides difficile Infection in Hematopoietic Stem Cell Transplant: A National Readmission Database Analysis, 2018-2020

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2024-09, Vol.24, p.S610-S610
• Main Authors: Atif Khan, Muhammad, Khan, Shahryar, Kashif Amin, Muhammad, Humayun Khan, Faiza, Alam Khan, Mashal, Ahmad, Aamer, Khan, Ahmad
• Format: Article
• Language: English
• Subjects: Clostridioides difficile infection; hematopoietic stem cell transplant; mortality
• ISSN: 2152-2650
• DOI: 10.1016/S2152-2650(24)01787-7

Clostridioides difficile infection (CDI) is the most common cause of infectious diarrhea in hospitalized patients. It causes considerable morbidity in cancer patients, with an incidence as high as 5% to 30% in hematopoietic stem cell transplant (HSCT). We aim to assess the predictors and outcomes of mortality from CDI in patients who had undergone HSCT. This is a retrospective cohort study of adult patients hospitalized in the USA from 2018 to 2020 in the National Readmission Database. IRB approval was not required because de-identified data were utilized. We included patients with index admission for the primary diagnosis of CDI using International Classification of Diseases-10 (ICD-10) code. Our primary outcome was inpatient mortality, while the secondary outcomes were independent predictors of inpatient mortality and health care utilization including total hospitalization cost (THC). We conducted the analysis using STATA software version 18.0, and multivariate regression analysis was conducted to adjust for potential confounders. We identified a total of 228,459 index admissions with CDI and classified patients into 2 groups based on HSCT status: HSCT (0.6%) and non-HSCT (NHSCT) (99.4%). Patients in the HSCT group were younger by a mean of 12 years (mean age 53.32), and 63.6% were female as compared to 46.5% in the NHSCT group. More patients were found to be malnourished in the HSCT group (20% vs 15%). The 30-day readmission rate was 2.9% in the HSCT group and 2.79% in the NHSCT group. The adjusted odds ratio (OR) for mortality was 1.68 (95% CI 0.96-2.94; P=0.06) in the HSCT group. Age, malnutrition, Charlson comorbidity index, thrombocytopenia, acute kidney injury (AKI), toxic megacolon, and ileus were significant predictors of mortality. Adjusted odds ratio of mortality was highest for ileus (OR 3.3, 95% CI 2.1-5.4; P