Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 14, Number 2, April 2021, pages 87-95

Clostridium difficile Infection Hospitalizations in the United States: Insights From the 2017 National Inpatient Sample

Figure 1. CDI hospitalization trends, 2010 - 2017. The number of hospitalizations with CDI as a principal or secondary diagnosis is depicted in the figure. CDI: Clostridium difficile infection.

Figure 2. Trends in CDI hospitalizations per 100,000 population, 2010 - 2017. The yearly rates of hospitalizations with CDI as a principal or secondary diagnosis per 100,000 US population are depicted in the figure. CDI: Clostridium difficile infection.

Figure 3. Rate of CDI hospitalizations per 100,000 population, by age group, sex, and region, 2017. CDI: Clostridium difficile infection.

Figure 4. Rates of CDI hospitalizations per 10,000 all-cause hospital stays, by age group, sex, and region, 2017. CDI: Clostridium difficile infection.

**Table 1.** Baseline Characteristics of CDI Hospitalizations in 2017
	All CDI	Principal CDI	Secondary CDI	All other hospitalizations
The rates of hospitalizations with CDI as the principal diagnosis, secondary diagnosis, and all (principal plus secondary) diagnosis are compared with hospitalizations rates for hospitalizations due to all other causes. CDI: Clostridium difficile infection.
Number of hospitalizations	329,460 (0.9% of all stays)	96,585 (29.3% of all CDI stays)	232,875 (70.7% of all CDI stays)	35,470,000
Mean age (years)	64.7	64.4	64.8	49.4
Female patients (%)	57.1	63.7	54.4	56.4
Insurance status (%)
Medicare	65.6	65.1	65.8	41.7
Medicaid	13.3	12.1	13.8	24.0
Private insurance	19.0	20.5	18.3	30.3
Uninsured	2.1	2.4	2.0	4.1
Severity of illness
APR-DG severity of illness, mean score	3.1	2.5	3.4	2.1
Percentage with APR-DG severity illness score: major or extreme loss of function (%)	79.8	51.0	91.7	33.2
APR-DG risk of mortality, mean score	2.7	2.1	2.9	1.8
Percentage with APR-DG risk of mortality score: major or extreme likelihood of dying (%)	60.0	37.7	69.2	24.9
Mortality rate (%)	6.1	1.3	8.1	1.9
Mean length of stay (days)	9.9	5.4	11.8	4.6

Table 1. Baseline Characteristics of CDI Hospitalizations in 2017

All CDI

Principal CDI

Secondary CDI

All other hospitalizations

The rates of hospitalizations with CDI as the principal diagnosis, secondary diagnosis, and all (principal plus secondary) diagnosis are compared with hospitalizations rates for hospitalizations due to all other causes. CDI: Clostridium difficile infection.

Number of hospitalizations

329,460 (0.9% of all stays)

96,585 (29.3% of all CDI stays)

232,875 (70.7% of all CDI stays)

35,470,000

Mean age (years)

64.7

64.4

64.8

49.4

Female patients (%)

57.1

63.7

54.4

56.4

Insurance status (%)

Medicare

65.6

65.1

65.8

41.7

Medicaid

13.3

12.1

13.8

24.0

Private insurance

19.0

20.5

18.3

30.3

Uninsured

2.1

2.4

2.0

4.1

Severity of illness

APR-DG severity of illness, mean score

3.1

2.5

3.4

2.1

Percentage with APR-DG severity illness score: major or extreme loss of function (%)

79.8

51.0

91.7

33.2

APR-DG risk of mortality, mean score

2.7

2.1

2.9

1.8

Percentage with APR-DG risk of mortality score: major or extreme likelihood of dying (%)

60.0

37.7

69.2

24.9

Mortality rate (%)

6.1

1.3

8.1

1.9

Mean length of stay (days)

9.9

5.4

11.8

4.6

**Table 2.** Rates of Comorbidities Associated With CDI Hospitalizations in 2017
Diagnoses	Principal CDI^a	Secondary CDI^b	All CDI
^aFor hospitalizations with CDI as the principal diagnosis, comorbidities were considered as secondary diagnoses. ^bFor hospitalizations with CDI as a secondary diagnosis, comorbidities were considered either as principal diagnosis or as other secondary diagnoses. CDI: Clostridium difficile infection.
Fluid and electrolyte disturbance	62,680	64.9%	145,735	62.6%	208,415	63.3%
Renal failure	22,605	23.4%	87,325	37.5%	109,930	33.4%
Septicemia	1,750	1.8%	99,230	42.6%	100,980	30.7%
Septic shock	550	0.6%	32,035	13.8%	32,585	9.9%
Ileus	1,995	2.1%	9,610	4.1%	11,605	3.5%
Ascites	2,190	2.3%	9,160	3.9%	11,350	3.5%
Hypoalbuminemia	1,885	2.0%	6,060	2.6%	7,945	2.4%
Peritonitis	450	0.5%	6,285	2.7%	6,735	2.0%
Perforation of intestine	150	0.2%	1,480	0.6%	1,630	0.5%
Toxic megacolon	355	0.4%	845	0.4%	1,200	0.4%

Table 2. Rates of Comorbidities Associated With CDI Hospitalizations in 2017

Diagnoses

Principal CDI^a

Secondary CDI^b

All CDI

Percentage of stays affected

^aFor hospitalizations with CDI as the principal diagnosis, comorbidities were considered as secondary diagnoses. ^bFor hospitalizations with CDI as a secondary diagnosis, comorbidities were considered either as principal diagnosis or as other secondary diagnoses. CDI: Clostridium difficile infection.

Fluid and electrolyte disturbance

62,680

64.9%

145,735

62.6%

208,415

63.3%

Renal failure

22,605

23.4%

87,325

37.5%

109,930

33.4%

Septicemia

1,750

1.8%

99,230

42.6%

100,980

30.7%

Septic shock

550

0.6%

32,035

13.8%

32,585

9.9%

Ileus

1,995

2.1%

9,610

4.1%

11,605

3.5%

Ascites

2,190

2.3%

9,160

3.9%

11,350

3.5%

Hypoalbuminemia

1,885

2.0%

6,060

2.6%

7,945

2.4%

Peritonitis

450

0.5%

6,285

2.7%

6,735

2.0%

Perforation of intestine

150

0.2%

1,480

0.6%

1,630

0.5%

Toxic megacolon

355

0.4%

845

0.4%

1,200

0.4%