Introduction Clostridioides difficile infection (CDI) leads to significant morbidity and mortality in hospitalized patients. We aim to investigate whether chronic kidney disease (CKD) or end-stage renal disease (ESRD) are predictors of mortality in admitted patients with CDI, and whether the presence of inflammatory bowel disease (IBD) has any impact on the mortality rate. Methods The data of 133,099 hospitalized patients with CDI were analyzed from the National Inpatient Sample (NIS) database from 2016 to 2018. Baseline risk factors were identified using ICD-10 codes. Propensity score matching was used to match CKD/ESRD patients with patients without kidney disease based on age, gender, and IBD status (Crohn's disease or ulcerative colitis). A multivariable logistic regression model was used to establish the relationship between variables and adjusted for underlying risk factors. The primary endpoint was all-cause mortality among hospitalized patients with CDI, particularly those with IBD. Results Our cohort included 133,099 hospitalized patients with CDI, among whom 20,700 (15.6%) had CKD, 12,178 (9.1%) had ESRD, and 6104 (4.6%) had IBD. The mean age was 74, 63, and 63 years (p0.05). However, ESRD patients had a significantly higher all-cause mortality rate (Odds ratio, 3.738, 95% CI 2.175-6.425) among hospitalized CDI patients with IBD compared to those without IBD (odds ratio, 1.612, 95% CI 1.486-1.749) (p<0.05). Conclusion Kidney disease, particularly ESRD, is associated with a significant increase in mortality in CDI patients with IBD compared to those without IBD. These findings highlight the importance of aggressive CDI management in patients with IBD and ESRD.
Sleiman et al. (Wed,) studied this question.