Investigating the Effects of Nosocomial Clostridioides difficile Infection Among Acute Leukemia Patients: Insights From the 2020 National Inpatient Sample

Authors

Zubair Hassan Bodla, HCA Florida North Florida HospitalFollow
Mariam Hashmi, HCA Florida North Florida HospitalFollow
Fatima Niaz, King Edward Medical University, Lahore, PakistanFollow
Umer Farooq, Saint Louis University, Saint Louis, MOFollow
Muhammad Jahanzeb Khalil, University of Alabama, Montgomery, ALFollow
Farhan Khalid, Monmouth Medical Center, Long Branch, NJFollow
Kipson Charles, HCA Florida North Florida HospitalFollow
Christopher L. Bray, HCA Florida North Florida HospitalFollow

Keywords

Clostridioides difficile; cross infection; nosocomial infection; precursor cell lymphoblastic leukemia-lymphoma; acute lymphoblastic leukemia; length of stay; hospital mortality

Disciplines

Hematology | Infectious Disease | Oncology | Preventive Medicine

Abstract

Background

Rising nosocomial Clostridioides difficile infections pose high risks, especially for immunocompromised leukemia patients, necessitating targeted research to enhance patient care and outcomes.

The objective of this study was to investigate the impact of nosocomial Clostridioides difficile infections (CDI) on patients hospitalized with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

Methods

Our study was a retrospective analysis of adult patients hospitalized with a primary diagnosis of ALL or AML, using the Nationwide Inpatient Sample (NIS) database for 2020. Primary outcomes included the incidence of nosocomial CDI and all-cause inpatient mortality. Secondary outcomes included hospital length of stay, resource utilization, and morbidity. Statistical analyses were conducted with STATA (address). Fisher's exact test was utilized to compare proportions, while the Student's t test was employed for continuous variables. Multivariate logistic and linear regression analyses were used to adjust for confounding variables.

Results

We found in 21 135 ALL and 58 560 AML adult patients that the CDI incidences were 2.77% and 3.0%, respectively. ALL and AML patients with CDI had adjusted mortality odds ratios of 3.02 (P = .003) and 1.51 (P = .02). Hospital length of stay was extended by mean differences of 10.16 days (ALL) and 8.33 days (AML) for those with CDI compared to those without it. In addition, patients with CDI displayed a significantly higher incidence of acute kidney injury, sepsis, vasopressor use, and intensive care unit admissions.

Conclusion

This study highlights the significant impact of CDI infections on health outcomes for leukemia patients, emphasizing the need for robust infection control measures, early detection, and aggressive management of CDI to improve patient outcomes and minimize healthcare costs.

Recommended Citation

Bodla, Zubair Hassan; Hashmi, Mariam; Niaz, Fatima; Farooq, Umer; Khalil, Muhammad Jahanzeb; Khalid, Farhan; Charles, Kipson; and Bray, Christopher L. (2024) "Investigating the Effects of Nosocomial Clostridioides difficile Infection Among Acute Leukemia Patients: Insights From the 2020 National Inpatient Sample," HCA Healthcare Journal of Medicine: Vol. 5: Iss. 6, Article 6.
DOI: 10.36518/2689-0216.1748
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol5/iss6/6