Dataset Information

Heart Failure Is a Risk Factor for Suffering and Dying of Clostridium difficile Infection. Results of a 15-Year Nationwide Study in Spain.

ABSTRACT: BACKGROUND:We aimed to (1) analyze time trends in the incidence and in-hospital outcomes of heart failure (HF) patients suffering Clostridioides difficile infection (CDI); (2) compare clinical characteristics of CDI patients between those with HF and matched non-HF patients; and (3) identify predictors of in-hospital mortality (IHM) among HF patients suffering CDI. METHODS:Retrospective study using the Spanish National Hospital Discharge Database from 2001 to 2015. Patients of age ?40 years with CDI were included. For each HF patient, we selected a year, age, sex, and readmission status-matched non-HF patient. RESULTS:We found 44,695 patients hospitalized with CDI (15.46% with HF). HF patients had a higher incidence of CDI (202.05 vs. 145.09 per 100,000 hospitalizations) than patients without HF (adjusted IRR 1.35; 95%CI 1.31-1.40). IHM was significantly higher in patients with HF when CDI was coded as primary (18.39% vs. 7.63%; p < 0.001) and secondary diagnosis (21.12% vs. 14.76%; p < 0.001). Among HF patient's predictor of IHM were older age (OR 8.80; 95%CI 2.55-20.33 for ?85 years old), those with more comorbidities (OR 1.68; 95%CI 1.12-2.53 for those with Charlson Comorbidity index ?2), and in those with severe CDI (OR 6.19; 95%CI 3.80-10.02). CONCLUSIONS:This research showed that incidence of CDI was higher in HF than non-HF patients. HF is a risk factor for IHM after suffering CDI.

SUBMITTER: Mendez-Bailon M

PROVIDER: S-EPMC7141109 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Heart Failure Is a Risk Factor for Suffering and Dying of <i>Clostridium difficile</i> Infection. Results of a 15-Year Nationwide Study in Spain.

Méndez-Bailón Manuel M Jiménez-García Rodrigo R Hernández-Barrera Valentín V Miguel-Díez Javier de J Miguel-Yanes José M de JM Muñoz-Rivas Nuria N Lorenzo-Villalba Noel N Carabantes-Alarcon David D Zamorano-León José J JJ Astasio-Arbiza Paloma P Ortega-Molina Paloma P López-de-Andrés Ana A

Journal of clinical medicine 20200225 3

<h4>Background</h4>We aimed to (1) analyze time trends in the incidence and in-hospital outcomes of heart failure (HF) patients suffering <i>Clostridioides difficile</i> infection (CDI); (2) compare clinical characteristics of CDI patients between those with HF and matched non-HF patients; and (3) identify predictors of in-hospital mortality (IHM) among HF patients suffering CDI.<h4>Methods</h4>Retrospective study using the Spanish National Hospital Discharge Database from 2001 to 2015. Patients ...[more]

PMID: 32106444

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Project description:ObjectivesTo investigate illness trajectories as reflected by healthcare utilisation, including hospital and intensive care unit admissions, consultations in general practice and home care provision, before death comparing people dying from chronic obstructive pulmonary disease (COPD), heart failure and cancer.DesignNationwide register-based cohort study.SettingData on all hospital admissions, including intensive care unit admissions, consultations in general practice and home care provision were obtained from nationwide Danish registries.ParticipantsAll adult decedents in Denmark dying from COPD, heart failure or cancer between 2006 and 2016.Outcome measuresFor each day within 5 years before death, we computed a daily prevalence proportion (PP) of being admitted to hospital or consulting a general practitioner. For each day within 6 months before death, we computed PPs of being admitted to intensive care or receiving home care. The PPs were plotted and compared by regression analyses adjusting for age, gender, comorbidity level, marital/cohabitation status, municipality and income level.ResultsAmong 1 74 086 patients dying from COPD (n=22 648), heart failure (n=11 498) or cancer (n=139 940), the PPs of being admitted to hospital or consulting a general practitioner showed similar steady progression and steep increase in the last year of life for all patient populations. The PP of being admitted to intensive care showed modest increase during the last 6 months of life, accelerating in the last month, for all patient populations. For patients with COPD and heart failure, the PP of receiving home care remained stable during the last 6 months of life but increased steadily for patients with cancer.ConclusionWe found limited differences in healthcare resource utilisation at the end of life for people with COPD, heart failure or cancer, indicating comparable illness trajectories.This supports the need to reconsider efforts in achieving equal access to palliative care interventions, which is still mainly offered to patients with cancer.

Dataset Information

Heart Failure Is a Risk Factor for Suffering and Dying of Clostridium difficile Infection. Results of a 15-Year Nationwide Study in Spain.

Publications

Heart Failure Is a Risk Factor for Suffering and Dying of <i>Clostridium difficile</i> Infection. Results of a 15-Year Nationwide Study in Spain.

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