Background: Rates of Clostridium difficile (CD) infections are increasing. Elderly patients may be at particular risk of recurrent CD infection. Little is known about the risk for CD readmission specifically in this age group.

Methods: A 5% random sample of Medicare data (2009-2011) was queried for patients surviving a hospitalization for CD by ICD-9 code. Demographic (age, sex, gender), clinical (Elixhauser index, gastrointestinal comorbidities), and hospitalization (length of stay, ICU admission) characteristics as well as exposure to antibiotics and interim non-CD hospitalization were compared for those with and without a readmission for CD. A multivariable survival analysis was used to determine predictors of readmission.

Results: Of 7,564 patients surviving a CD hospitalization, 8.5% were readmitted with CD in a median of 25 days (interquartile range (IQR) 14-57). In multivariable survival analyses, interim non-CD hospital exposure was the strongest predictor of CD readmission (hazard ration (HR) 3.75 95%, confidence interval (CI) 3.2-4.42). Oral and intravenous/intramuscular (IV/IM) antibiotic use, Elixhauser index, and CD as the primary diagnosis also increased the risk of CD readmission. Discharge to hospice, long-term care or a skilled nursing facility decreased the odds of CD readmission.

Conclusion: Hospital exposure and antibiotic use put elderly patients at risk of CD readmission. Exposure to these factors should be minimized in the immediate post discharge period.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462125PMC
http://dx.doi.org/10.1007/s11605-014-2638-6DOI Listing

Publication Analysis

Top Keywords

risk readmission
12
clostridium difficile
8
sample medicare
8
elderly patients
8
patients risk
8
patients surviving
8
surviving hospitalization
8
interim non-cd
8
multivariable survival
8
hospital exposure
8

Similar Publications

Objective: Frailty has become an increasingly recognized perioperative risk stratification tool. While frailty has been strongly correlated with worsening surgical outcomes, the individual determinants of frailty have rarely been investigated in the setting of aortic disease. The aim of this study was to examine the determinants of an 11-factor modified frailty index (mFI-11) on mortality and postoperative complications in patients undergoing endovascular aortic aneurysm repair (EVAR).

View Article and Find Full Text PDF

Introduction And Objectives: Cardiac amyloidosis (CA) is a prevalent yet underdiagnosed heart condition characterized by the abnormal accumulation of amyloid fibres, frequently resulting in heart failure (HF), particularly in older people. Despite advancements in non-invasive diagnostic techniques and treatments, the epidemiology of CA patients remains inadequately understood. This nationwide retrospective observational study sought to comprehensively investigate CA patients' characteristics, mortality, and readmission patterns.

View Article and Find Full Text PDF

Comparison of complications and surgery outcomes in skin closure methods following cesarean sections.

Arch Gynecol Obstet

January 2025

Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.

Purpose: This study aimed to assess the impact of absorbable subcutaneous staples for skin closure in cesarean delivery (CD) on maternal morbidity.

Methods: A retrospective cohort study was conducted at a single tertiary university-affiliated medical center between January 2011 and April 2022. In 2020, a new technique involving absorbable subcutaneous staples for skin closure in CD was introduced.

View Article and Find Full Text PDF

Purpose: The adoption of robotic-assisted total hip arthroplasty (THA) is increasingly widespread, yet its influence on outcomes in outpatient surgery remains uncertain. This study aimed to evaluate whether robotic assistance reduces the rate of 90-day postoperative events in patients undergoing outpatient THA, compared to those in inpatient procedures.

Methods: This historical-prospective cohort study analyzed 706 primary THA cases performed between January 2017 and January 2023 by three senior surgeons.

View Article and Find Full Text PDF

Background: Limited data exist describing the influence of pharmacist-led transition of care (TOC) services in safety-net hospital settings.

Objective: This analysis assessed the impact of pharmacist-led TOC services on hospital readmissions in a high-risk managed Medicaid population impacted by housing instability, substance use disorder (SUD), and mental health issues.

Methods: A retrospective evaluation of patients who received safety-net hospital-based TOC pharmacy services between January 1, 2022, and December 31, 2022, was conducted.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!