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The prolongation of length of stay because of Clostridium difficile infection.
- Source :
-
American journal of infection control [Am J Infect Control] 2014 Feb; Vol. 42 (2), pp. 164-7. Date of Electronic Publication: 2013 Dec 02. - Publication Year :
- 2014
-
Abstract
- Background: Clostridium difficile infection (CDI) possibly extends hospital length of stay (LOS); however, the current evidence does not account for the time-dependent bias, ie, when infection is incorrectly analyzed as a baseline covariate. The aim of this study was to determine whether CDI increases LOS after managing this bias.<br />Methods: We examined the estimated extra LOS because of CDI using a multistate model. Data from all persons hospitalized >48 hours over 4 years in a tertiary hospital in Australia were analyzed. Persons with health care-associated CDIs were identified. Cox proportional hazards models were applied together with multistate modeling.<br />Results: One hundred fifty-eight of 58,942 admissions examined had CDI. The mean extra LOS because of infection was 0.9 days (95% confidence interval: -1.8 to 3.6 days, P = .51) when a multistate model was applied. The hazard of discharge was lower in persons who had CDI (adjusted hazard ratio, 0.42; P < .001) when a Cox proportional hazard model was applied.<br />Conclusion: This study is the first to use multistate models to determine the extra LOS because of CDI. Results suggest CDI does not significantly contribute to hospital LOS, contradicting findings published elsewhere. Conversely, when methods prone to result in time-dependent bias were applied to the data, the hazard of discharge significantly increased. These findings contribute to discussion on methods used to evaluate LOS and health care-associated infections.<br /> (Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Australia epidemiology
Child
Child, Preschool
Clostridium Infections microbiology
Cross Infection microbiology
Diarrhea microbiology
Female
Humans
Male
Middle Aged
Tertiary Care Centers
Young Adult
Clostridioides difficile isolation & purification
Clostridium Infections epidemiology
Cross Infection epidemiology
Diarrhea epidemiology
Length of Stay statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3296
- Volume :
- 42
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- American journal of infection control
- Publication Type :
- Academic Journal
- Accession number :
- 24290226
- Full Text :
- https://doi.org/10.1016/j.ajic.2013.07.006