Disproportionate rise in clostridium difficile -associated hospitalizations among us youth with inflammatory bowel disease, 1997-2011

Kelly C. Sandberg*, Matthew M. Davis, Achamyeleh Gebremariam, Jeremy Adler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives: Our aim was to characterize the temporal changes in burden that Clostridium difficile infection (CDI) added to the hospital care of children and young adults with inflammatory bowel disease (IBD) in the United States. Methods: Retrospective analysis of annual, nationally representative samples of children and young adults with IBD. Results: There was a 5-fold increase in IBD hospitalizations with CDI from 1997 to 2011 (P for trend <0.01). During the same period, IBD hospitalizations without CDI increased 2-fold (P for trend <0.01). Mean length of stay for IBD hospitalizations with CDI was consistently longer than that for hospitalizations without CDI and did not significantly change over time (P for trend=0.47). CDI-related total hospital days in the United States rose from 1702 to 10,194 days per million individuals per year from 1997 to 2011 (P for trend <0.01). Children and young adults hospitalized with CDI had a significantly lower odds of colectomy (0.31) compared with those without CDI. Total charges for CDI-related hospitalizations among children and young adults in the United States rose from $8.7 million in 1997 to $68.2 million in 2011. Conclusions: A widening gap in burden has opened between IBD hospitalizations with and without CDI during the last decade and a half. CDI-related hospitalizations are associated with disproportionately longer lengths of stay, more hospital days, and more charges than hospitalizations without CDI over time. Further work within health systems, hospitals, and practices can help us better understand this enlarging gap to improve clinical care for this vulnerable population.

Original languageEnglish (US)
Pages (from-to)486-492
Number of pages7
JournalJournal of pediatric gastroenterology and nutrition
Volume60
Issue number4
DOIs
StatePublished - Apr 9 2015

Keywords

  • Clostridium difficile
  • Nationwide Inpatient Sample
  • inflammatory bowel disease
  • national trends
  • variance-weighted regression

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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