| Summary: | Background: We aimed to (1) analyze time trends in the incidence and in-hospital outcomes of heart failure (HF) patients suffering <i>Clostridioides difficile</i> infection (CDI); (2) compare clinical characteristics of CDI patients between those with HF and matched non-HF patients; and (3) identify predictors of in-hospital mortality (IHM) among HF patients suffering CDI. Methods: Retrospective study using the Spanish National Hospital Discharge Database from 2001 to 2015. Patients of age ≥40 years with CDI were included. For each HF patient, we selected a year, age, sex, and readmission status-matched non-HF patient. Results: We found 44,695 patients hospitalized with CDI (15.46% with HF). HF patients had a higher incidence of CDI (202.05 vs. 145.09 per 100,000 hospitalizations) than patients without HF (adjusted IRR 1.35; 95% CI 1.31−1.40). IHM was significantly higher in patients with HF when CDI was coded as primary (18.39% vs. 7.63%; <i>p</i> < 0.001) and secondary diagnosis (21.12% vs. 14.76%; <i>p</i> < 0.001). Among HF patient’s predictor of IHM were older age (OR 8.80; 95% CI 2.55−20.33 for ≥85 years old), those with more comorbidities (OR 1.68; 95% CI 1.12−2.53 for those with Charlson Comorbidity index ≥2), and in those with severe CDI (OR 6.19; 95% CI 3.80−10.02). Conclusions: This research showed that incidence of CDI was higher in HF than non-HF patients. HF is a risk factor for IHM after suffering CDI.
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