Trend of <i>Clostridium difficile</i> colitis infection and ileus among patients admitted to the hospital with common malignancies in 2022: An analysis of the National Inpatient Sample.

Abstract

e24036 Background: Clostridium difficile (C. difficile) infection is a prevalent condition with a high mortality risk, particularly among immunocompromised patients, such as those suffering from malignancies. This study aims to identify modifiable factors that could help reduce the mortality risk and prevalence of C. difficile infection (CDI) in cancer patients. Methods: The National Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project (HCUP) for 2022 was used to identify patients admitted with a primary diagnosis of lung, colorectal, pancreatic, or breast cancer. This cohort was divided into two groups: those who developed CDI during hospitalization and those who did not. Among the CDI group, patients were further categorized into those who developed ileus and those who did not. Logistic and linear regression models were used to evaluate statistically significant differences based on age, race, hospital bed size, teaching status, income, gender, type of admission, and hospital region. Results: A total of 275,794 patients with a primary diagnosis of lung, pancreatic, breast, or colorectal cancer were included in the analysis. Of these, 1,065 (0.38%) developed CDI during hospitalization, and 17% of those with CDI subsequently developed ileus. Patients with CDI had a significantly longer hospital stay, with a median of 14.61 days compared to 6.19 days for those without CDI (p &lt; 0.001). The length of stay and hospital costs were significantly higher among patients with CDI. Additionally, 78.4% of patients with CDI were admitted on weekdays (p &lt; 0.001), and 80% of these admissions were non-elective. Statistically significant differences were observed in median household income (p = 0.0388) and hospital ownership (p = 0.0397) between patients who developed CDI and those who did not. The epidemiological characteristics of the patient population are detailed in the table below. Conclusions: This analysis identifies key modifiable factors that can reduce the burden of CDI and its associated mortality in cancer patients. Hospital ownership and the day of admission were among the factors most strongly influencing the development of CDI. By addressing these factors, clinicians can optimize care and potentially reduce the prevalence and mortality associated with CDI in cancer patients. Comparison of different characteristics between patients with and without C. difficile infection. Developed C.Diff No C.Diff P- value Age 69.16 67.34 &lt;0.001 LOS 14.61 days 6.19 days &lt;0.001 Total charges 171034 106979 &lt;0.001 Female 52% 53% 0.6331 Elective admission 20% 48% &lt;0.001 Weekend admission 21% 12% &lt;0.001 Ileus 16% 5% &lt;0.000