P0899 - Prevalence and Inpatient Outcomes Of Clostridium difficile Infection in Inflammatory Bowel disease

Anwar Uddin, MD¹, Prashil Dave, MD², Peter Lymberopoulos, MD¹, Madia Ahad, MD¹, Rafat Uddin, BA¹, Rahat Uddin, MS¹, Afgal Ahad, MD^1
1SUNY Downstate Medical Center, Brooklyn, NY; ²State University of New York Downstate, Brooklyn, NY

Introduction: Clostridium difficile infection (CDI) is a significant complication in patients with inflammatory bowel disease (IBD), often occurring in those with a history of antibiotic use and immunosuppressive therapy. This study aimed to investigate the outcomes of CDI in IBD patients using the nationwide database.

Methods: We used the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) to identify adult patients with IBD during 2016 – 2020 using ICD-10-CM codes. We used ICD-10-CM codes to identify patients with CDI. Main outcomes were in-hospital mortality, length of stay (LOS), and hospital costs and we also examined secondary outcomes including acute GI bleed (AGIB), acute pancreatitis, chronic pancreatitis, colonic polyps, colon cancer, hepatorenal syndrome (HRS), liver cirrhosis, and diverticulitis. We evaluated the association between CDI and outcomes using survey based multivariate logistic regression models for in-hospital mortality and secondary outcomes, Poisson regression for LOS, and generalized linear model with gamma distribution and log link for hospitalization cost. Models were adjusted for age, sex, race and ethnicity, primary payer, Charlson comorbidity index, hospital bed size, hospital region and hospital teaching status.

Results: We identified a total of 1,550,145 IBD hospitalizations between 2016 and 2020 in the United States and 66,140 (4.27%)) of them were associated with CDI. IBD patients with CDI had significantly higher in-patient compared to those without CDI (3.4% vs 1.5%, adjusted OR: 2.04, 95%CI: 1.84 – 2.26, P < 0.001, Table 1). IBD patients with CDI had an increased length of stay (8.1 ± 0.09 vs 5.2 ± 0.02 days, P < 0.001) and an increased cost of hospitalization ($19,670 ± 321 vs $14,876 ± 86, P < 0.001, Table 1). Diagnoses of AGIB, HRS and diverticulitis were significantly higher in IBD patients with CDI compared to those without CDI (16% vs 12%, p < 0.001; 0.2% vs 0.1%, p = 0.018; 2.1% vs 1.6%, p < 0.001; respectively) while acute pancreatitis had lower rates in IBD patients with CDI (1.4% vs 1.9%, P < 0.001).

Discussion: CDI occurs frequently among patients with IBD and is associated with higher in‐hospital mortality, length of stay, cost of hospitalization along with higher AGIB, HRS and diverticulitis diagnoses.


Disclosures:


Anwar Uddin, MD¹, Prashil Dave, MD², Peter Lymberopoulos, MD¹, Madia Ahad, MD¹, Rafat Uddin, BA¹, Rahat Uddin, MS¹, Afgal Ahad, MD¹. P0899 - Prevalence and Inpatient Outcomes Of <i>Clostridium difficile</i> Infection in Inflammatory Bowel disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.