Heart Failure Is a Risk Factor for Suffering and Dying of <i>Clostridium difficile</i> Infection. Results of a 15-Year Nationwide Study in Spain

• Main Authors: Manuel Méndez-Bailón, Rodrigo Jiménez-García, Valentín Hernández-Barrera, Javier de Miguel-Díez, José M. de Miguel-Yanes, Nuria Muñoz-Rivas, Noel Lorenzo-Villalba, David Carabantes-Alarcon, José J. Zamorano-León, Paloma Astasio-Arbiza, Paloma Ortega-Molina, Ana López-de-Andrés
• Format: Article
• Language: English
• Published: MDPI AG 2020-02-01
• Series: Journal of Clinical Medicine
• Subjects: <i>clostridium difficile</i> infection; heart failure; in-hospital mortality; hospitalization; incidence
• Online Access: https://www.mdpi.com/2077-0383/9/3/614

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 &#8805;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&#8722;1.40). IHM was significantly higher in patients with HF when CDI was coded as primary (18.39% vs. 7.63%; <i>p</i> &lt; 0.001) and secondary diagnosis (21.12% vs. 14.76%; <i>p</i> &lt; 0.001). Among HF patient&#8217;s predictor of IHM were older age (OR 8.80; 95% CI 2.55&#8722;20.33 for &#8805;85 years old), those with more comorbidities (OR 1.68; 95% CI 1.12&#8722;2.53 for those with Charlson Comorbidity index &#8805;2), and in those with severe CDI (OR 6.19; 95% CI 3.80&#8722;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.