High 30-day readmission rates associated with Clostridiumdifficile infection

• Published in: American journal of infection control 2019-08, Vol.47 (8), p.922-927
• Main Authors: Verheyen, Elijah, Dalapathi, Vijay, Arora, Shilpkumar, Patel, Kalpesh, Mankal, Pavan Kumar, Kumar, Varun, Lung, Edward, Kotler, Donald P., Grinspan, Ari
• Format: Article
• Language: English
• Subjects: Clostridium difficile; Readmission; Risk factors
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2019.01.007

•One in five patients admitted with C. difficile is readmitted within 30 days.•Recurrent C difficile is the leading cause of readmission.•Female sex, renal disease, and anemia increase C difficile readmission risk.•Discharge home, as opposed to facility, increases C difficile readmission risk. Clostridium difficile infection (CDI) is a leading cause of community-onset and healthcare–associated infection, with high recurrence rates, and associated high morbidity and mortality. We report national rates, leading causes, and predictors of hospital readmission for CDI. Retrospective study of data from the 2013 Nationwide Readmissions Database of patients with a primary diagnosis of CDI and re-hospitalization within 30-days. A multivariate regression model was used to identify predictors of readmission. Of 38,409 patients admitted with a primary diagnosis of CDI, 21% were readmitted within 30-days, and 27% of those patients were readmitted with a primary diagnosis of CDI. Infections accounted for 47% of all readmissions. Female sex, anemia/coagulation defects, renal failure/electrolyte abnormalities and discharge to home (versus facility) were 12%, 13%, 15%, 36%, respectively, more likely to be readmitted with CDI. We found that 1-in-5 patients hospitalized with CDI were readmitted to the hospital within 30-days. Infection comprised nearly half of these readmissions, with CDI being the most common etiology. Predictors of readmission with CDI include female sex, history of renal failure/electrolyte imbalances, anemia/coagulation defects, and being discharged home. CDI is associated with a high readmission risk, with evidence of several predictive risks for readmission.