1401. Thirty- Day Readmissions due to Clostridium difficile Infection-What Do We Know?
Session: Poster Abstract Session: Clostridium difficile
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • CDI Poster_IDW_Sarit Sharma.pdf (717.5 kB)
  • Background:

    Through Value Based Purchasing (VBP), CMS has begun to decrease payments to hospitals with excessive 30-day readmissions. VBP will soon also link payments to care reliability performance which can have major implications to hospitals. We sought to identify Clostridium difficileInfection (CDI) as a cause of increased length of stay and 30-day readmission at a tertiary care center.


    Discharge data was analyzed between July 1, 2011 through June 30, 2012 at an 8-hospital tertiary care health system in metropolitan Detroit. All inpatients discharged from any of the 8 hospitals during the study period with a diagnosis of Clostridium difficileenterocolitis ICD9 008.45 code were included in the analysis. A comparison was made between all cause 30-day readmissions (All-RA) vs. 30-day readmissions attributable to CDI present on admission (CDI-RA). An additional analysis was performed to compare average all cause length of stay (ALL-LOS) for 30-day readmissions and days to readmission (ALL-DR) vs. average length of stay (CLOS) and days to readmission (CDI-DR) for 30-day readmissions attributable to CDI. 


    There were a total of 76,501 patients discharged from the health system during the 12 month study period. A total of 714 discharges had a diagnosis of CDI, 390 with CDI present on admission (POA).  The All-RA was 7951(11%) and CDI –RA was 140 (1.76%).  The ALL-LOS was 4.45 days and CLOS for CDI POA patients was 9.0 days. For both populations, the average ALL-DR and CDI-DR was 12.9 and 12.7 days respectively. The ALL-LOS and CLOS was 5.5 and 6.1 days respectively. The average cost per day for CDI present on admission was $1720/day.


    CDI-RA accounted for 1.76% of the total readmissions during the study period. Similar to other readmit causes to our health system, CDI related readmissions occurred within 13 days of index admission discharge averaging an additional 6 day LOS.  At an average cost of $1720/day, a reduction in readmission secondary to CDI can provide tremendous cost savings. This calls for better infection control and antibiotic stewardship measures to prevent CDI related readmissions.

    Paru Patel, Pharm D, Detroit Medical Center/Wayne State University, Detroit, MI, Sarit Sharma, MD, Preventive Medicine, Dayanand Medical College and Hospital, Ludhiana, India, Ludhiana, India; Infectious Diseases, Detroit Medical Center and Wayne State University, Detroit, MI and Teena Chopra, MD, MPH, Infectious Diseases, Detroit Medical Center/ Wayne State University, Detroit, MI


    P. Patel, None

    T. Chopra, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.