MedicalResearch.com Interview with:
Esther van Kleef
London School of Hygiene and Tropical Medicine,
London, UK
Medical Research: What are the main findings of the study?
Response: Existing evidence reveals a wide variation in estimated excess length of hospital stay (LoS) associated with healthcare-acquired
C. difficile infection (HA-CDI), ranging from 2.8 to 16.1 days. Few studies considered the time-dependent nature of healthcare-acquired
C. difficile (i.e. patients that spent a longer time in hospital have an increased risk of infection), and none have considered the impact of severity of healthcare-acquired
C. difficile on expected delayed discharge. Using a method that adjusted for this so-called time-dependent bias, we found that compared to non-infected patients, the excess length of stay of severe patients (defined by increased white blood cell count, serum creatinine, or temperature, or presence of colitis) was on average, twice (11.6 days; 95% CI: 3.6-19.6) that of non-severe cases (5.3 days; 95% CI: 1.1-9.5). However, severely infected patients did not have a higher daily risk of in-hospital death than non-severe patients. Overall, we estimated that healthcare-acquired
C. difficile prolonged hospital stay with an average of ~7 days (95% CI: 3.5-10.9) and increased in-hospital daily death rate with 75% (Hazard Ratio (HR): 1.75; 95% CI: 1. 16 – 2.62).
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