Increasing Hospitalization and Death Possibly Due to Clostridium difficile Diarrheal Disease
1998

Increased Hospitalizations and Deaths from Diarrhea Linked to Clostridium difficile

publication Evidence: moderate

Author Information

Author(s): Floyd Frost, Gunther F. Craun, Rebecca L. Calderon

Primary Institution: Southwest Center for Managed Care Research

Hypothesis

Has the incidence of hospitalizations or deaths due to infectious diarrhea changed during the past decade, and if so, which specific pathogens are responsible for these changes?

Conclusion

The study found that hospitalization and death rates due to bacterial causes of diarrhea have increased, particularly due to Clostridium difficile infections.

Supporting Evidence

  • Hospitalization rates for bacterial causes increased more than fourfold from 1985 to 1994.
  • Age-adjusted death rates for bacterial causes increased from 0.060 per 100,000 in 1980 to 0.104 per 100,000 in 1994.
  • 73% of hospitalizations due to uncoded enteric pathogens were attributed to Clostridium difficile infection.
  • 88% of Washington State death certificates coded to unspecified enteric pathogen infections listed C. difficile infection.

Takeaway

Doctors looked at how many people got sick or died from diarrhea over the years and found that more people are getting sick from a germ called Clostridium difficile.

Methodology

The study analyzed national hospitalization and death data from 1980 to 1996, focusing on enteric pathogens and using ICD9 coding.

Potential Biases

Potential bias due to improved coding practices and diagnostic accuracy over time.

Limitations

The study is based on data from one hospital system and one state, which may not represent national trends.

Participant Demographics

The study included data on various age groups, particularly focusing on children and the elderly.

Statistical Information

P-Value

p < 0.00001

Statistical Significance

p < 0.00001

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