Clostridium difficile Colitis: Factors Associated with Outcome and Assessment of Mortality at a National Level

Previous descriptions of Clostridium difficile colitis (CDC) epidemics may overestimate cost and mortality of CDC. An analysis of the 2007 Nationwide Inpatient Sample was performed. Patients with CDC (N = 41,207) were compared to a propensity score-matched cohort of patients without CDC. Average length of stay was longer for CDC patients by 5 days (p < 0.001). Mortality was higher for the CDC cohort (9.4% vs. 8.6%; p < 0.001) though the absolute difference was small. Mean hospital costs were 56% higher for CDC patients (p < 0.001). Higher odds of death with CDC were associated with small hospitals and self-pay patients. Chronic renal failure and diabetes were associated with lower hospital costs and lower odds of death in the CDC cohort. CDC is not as deadly of a disease as it may be perceived to be at larger hospitals, and mortality was actually unaffected by certain serious comorbidities. CDC is expensive due to a longer hospital stay.