Abstract
Background
Data on the incidence and burden of Clostridium difficile infection (CDI) in Asia is limited.
Objectives
To evaluate the incidence and burden of CDI in Thailand.
Methods
We used 2010 Nationwide Hospital Admission Data, which included the diagnosis of digestive disorders from various causes coded using the ICD-10. Patients with a diagnosis of Clostridium difficile (ICD10-A07) aged >18 years, were included. Their baseline characteristics, clinical outcomes, and risk factors for CDI were analyzed. Length of hospital stay (LOS), mortality rate, and hospital expenses were used as indicators to evaluate the burden of CDI in Thailand.
Results
Of 4,863,935 admissions in 2010, 554 patients in 570 admissions (0.01%) were diagnosed with CDI. Of these, 106 (19.1%) died during the index hospitalization, and 98.1% had at least one comorbidity. The mean LOS for patients with CDI was longer than with other colitis (P < 0.001) and was also significantly longer for those who died during the index admission, compared with those who survived during the index admission (P = 0.04). The hospital expense for those who died was significantly higher than for those who survived (P < 0.001). From a multivariate analysis, age ≥85 years old, comorbidity, and sepsis were risk factors for mortality during admission with adjusted odds ratios of 2.40, 7.4, and 5.14, respectively.
Conclusions
The calculated burden of CDI in Thais is high; although the incidence of CDI is lower in Thailand than in Western countries. The mortality relates to the elderly age-group and comorbidity, especially sepsis.