Clostridium difficile is an important cause of diarrhea in hospitalized patients.
An increasing number of cases of C difficile colitis occur in patients with inflammatory bowel disease (IBD).
|Patients in the C difficile-IBD group stayed in the hospital for 3 days longer|
Dr Ananthakrishnan and colleagues from Wisconsin, USA estimated the potential excess morbidity and mortality associated with C difficile in hospitalized patients with inflammatory bowel disease.
The research team examined data from the Nationwide Inpatient Sample of patients hospitalized with both C difficile colitis and inflammatory bowel disease compared with those hospitalized for either condition alone.
The team's primary outcome was in-hospital mortality.
A subgroup analysis was also performed comparing outcomes of C difficile infection in patients with Crohn's disease, and ulcerative colitis.
The researchers diagnosed 2,804 discharges as having both C difficile, and inflammatory bowel disease.
The team reported that 44, 400 discharges had C difficile alone, and 77, 366 had inflammatory bowel disease alone.
The team found that on multivariate analysis, patients in the C difficile-inflammatory bowel disease group had a 4 times greater mortality than patients admitted to hospital for inflammatory bowel disease alone or C difficile alone.
The researchers noted that patients in the C difficile-inflammatory bowel disease group stayed in the hospital for 3 days longer.
The team found that significantly higher mortality, endoscopy and surgery rates in patients with ulcerative colitis compared with Crohn's disease.
No significant difference in length of stay or median hospital charge between the 2 groups was seen.
Dr Ananthakrishnans' team concluded, "C difficile colitis is associated with a significant healthcare burden in hospitalized patients with inflammatory bowel disease."
"It carries a higher mortality than in patients with C difficile without underlying inflammatory bowel disease."