Costs of Clostridium difficile infection in pediatric operations: A propensity score-matching analysis

Afif N. Kulaylat, Dorothy V. Rocourt, Abigail B. Podany, Brett W. Engbrecht, Marianne Twilley, Mary C. Santos, Robert E. Cilley, Christopher S. Hollenbeak, Peter W. Dillon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The purpose of this analysis was to assess the burden of . Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. Methods: There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of . C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of . C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of . C difficile infection on these outcomes. Results: The overall prevalence of . C difficile infection in the sampled cohort was 0.30%, with an increasing trend of . C difficile infection over time in non-children's hospitals (P < .001). . C difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P < .001). An estimated 1,438 children developed . C difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to . C difficile infection were 5.8 days and $12,801 (P < .001), accounting for 8,295 days spent in the hospital and $18.4 million (2012 USD) in spending annually. Conclusion: . C difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of . C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection.

Original languageEnglish (US)
JournalSurgery
DOIs
StateAccepted/In press - 2016

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Clostridium Infections
Propensity Score
Clostridium difficile
Pediatrics
Costs and Cost Analysis
Infection
Inpatients
Urban Hospitals
Operative Surgical Procedures
Cross Infection
Teaching Hospitals
Population
Comorbidity
Thorax
Logistic Models
Databases

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{5509c35db84242e19e7017063b7a7d80,
title = "Costs of Clostridium difficile infection in pediatric operations: A propensity score-matching analysis",
abstract = "Background: The purpose of this analysis was to assess the burden of . Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. Methods: There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of . C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of . C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of . C difficile infection on these outcomes. Results: The overall prevalence of . C difficile infection in the sampled cohort was 0.30{\%}, with an increasing trend of . C difficile infection over time in non-children's hospitals (P < .001). . C difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P < .001). An estimated 1,438 children developed . C difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to . C difficile infection were 5.8 days and $12,801 (P < .001), accounting for 8,295 days spent in the hospital and $18.4 million (2012 USD) in spending annually. Conclusion: . C difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of . C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection.",
author = "Kulaylat, {Afif N.} and Rocourt, {Dorothy V.} and Podany, {Abigail B.} and Engbrecht, {Brett W.} and Marianne Twilley and Santos, {Mary C.} and Cilley, {Robert E.} and Hollenbeak, {Christopher S.} and Dillon, {Peter W.}",
year = "2016",
doi = "10.1016/j.surg.2016.10.020",
language = "English (US)",
journal = "Surgery",
issn = "0039-6060",
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Costs of Clostridium difficile infection in pediatric operations : A propensity score-matching analysis. / Kulaylat, Afif N.; Rocourt, Dorothy V.; Podany, Abigail B.; Engbrecht, Brett W.; Twilley, Marianne; Santos, Mary C.; Cilley, Robert E.; Hollenbeak, Christopher S.; Dillon, Peter W.

In: Surgery, 2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Costs of Clostridium difficile infection in pediatric operations

T2 - A propensity score-matching analysis

AU - Kulaylat, Afif N.

AU - Rocourt, Dorothy V.

AU - Podany, Abigail B.

AU - Engbrecht, Brett W.

AU - Twilley, Marianne

AU - Santos, Mary C.

AU - Cilley, Robert E.

AU - Hollenbeak, Christopher S.

AU - Dillon, Peter W.

PY - 2016

Y1 - 2016

N2 - Background: The purpose of this analysis was to assess the burden of . Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. Methods: There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of . C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of . C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of . C difficile infection on these outcomes. Results: The overall prevalence of . C difficile infection in the sampled cohort was 0.30%, with an increasing trend of . C difficile infection over time in non-children's hospitals (P < .001). . C difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P < .001). An estimated 1,438 children developed . C difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to . C difficile infection were 5.8 days and $12,801 (P < .001), accounting for 8,295 days spent in the hospital and $18.4 million (2012 USD) in spending annually. Conclusion: . C difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of . C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection.

AB - Background: The purpose of this analysis was to assess the burden of . Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. Methods: There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of . C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of . C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of . C difficile infection on these outcomes. Results: The overall prevalence of . C difficile infection in the sampled cohort was 0.30%, with an increasing trend of . C difficile infection over time in non-children's hospitals (P < .001). . C difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P < .001). An estimated 1,438 children developed . C difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to . C difficile infection were 5.8 days and $12,801 (P < .001), accounting for 8,295 days spent in the hospital and $18.4 million (2012 USD) in spending annually. Conclusion: . C difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of . C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection.

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UR - http://www.scopus.com/inward/citedby.url?scp=85009354114&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2016.10.020

DO - 10.1016/j.surg.2016.10.020

M3 - Article

C2 - 28024858

AN - SCOPUS:85009354114

JO - Surgery

JF - Surgery

SN - 0039-6060

ER -