0
Transplantation |

Clostridium difficile Associated Diarrhea in Hospitalized Lung Transplant Recipients: A Nationwide Analysis

Vijaya Sivalingam Ramalingam, MD; Gagan Kumar, MD; Tilottama Majumdar, MD
Author and Funding Information

Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI


Chest. 2013;144(4_MeetingAbstracts):1012A. doi:10.1378/chest.1703426
Text Size: A A A
Published online

Abstract

SESSION TITLE: Lung Transplantation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Studies on Clostridium difficile associated diarrhea (CDAD) prevalence and outcomes in lung transplant recipients are limited to data from single centers. The data with regards to nationwide prevalence and outcomes are lacking.

METHODS: Using the Nationwide Inpatient Sample from 2008, adult lung transplant recipients (LT) with CDAD were identified with ICD-9-CM code. The outcomes examined were prevalence of CDAD, severity of CDAD, its effects on inpatient mortality, length of stay and hospitalization charges. We defined severe CDAD if the patient developed megacolon, perforation, peritonitis or underwent colectomy in same admission.

RESULTS: There were 16,070 discharges for LT in 2008. 783 of these discharges (0.05%) had CDAD. In the non-transplant population, the prevalence of CDAD was 0.99%. When we performed adjusted analysis for non-transplant recipients, CDAD was a significant predictor for mortality in LT recipients (OR 1.75, 95% CI 1.69-1.80). The severity of CDAD was significantly higher in lung transplant patients. Colectomy rates were significantly higher in LT patients with CDAD than without CDAD (2.5% vs. 0.5%, p < 0.001). Bowel perforation was significantly higher in LT patients with CDAD than without CDAD (1.3% vs. 0.2%, p < 0.001). Peritonitis was significantly higher in LT patients with CDAD than without CDAD (1.85% vs. 0.32%, p < 0.001). In survivors, the mean length of stay was longer in those with CDAD than without CDAD (18.6 days vs. 10.6 days, p<0.001). In non-survivors, the mean length of stay was longer in those with CDAD than without CDAD (40.4 days vs. 30.9 days, p<0.001). In LT patients with CDAD, hospitalization charges were higher with a mean of $209116.7 (95% CI = $138364.2-$279869.1) when compared to a mean of $130149.9 in LT patients without CDAD (95% CI = $84275.7-$176024.1).

CONCLUSIONS: The prevalence and severity of CDAD was higher for LT patients versus non-LT patients.

CLINICAL IMPLICATIONS: CDAD was found to be an independent risk factor for mortality in hospitalized LT patients. CDAD also increased the burden on health care by increasing the length of stay and hospital costs. This emphasizes the importance of early diagnosis and the appropriate initiation of treatment for CDAD in LT patients.

DISCLOSURE: The following authors have nothing to disclose: Vijaya Sivalingam Ramalingam, Gagan Kumar, Tilottama Majumdar

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543