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Open AccessArticle

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

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Internal Medicine Department, Clínico San Carlos University Hospital, 28040 Madrid, Spain
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Medicine Department, Complutense University of Madrid (UCM), 28040 Madrid, Spain
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Clínico San Carlos Hospital Biomedical Research Institute (IdISSC), 28040 Madrid, Spain
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Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
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Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain
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Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Facultad de Medicina, Universidad Complutense de Madrid (UCM), 28009 Madrid, Spain
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Medicine Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
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Service de Médecine Interne, Diabètes et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 614; https://doi.org/10.3390/jcm9030614
Received: 11 January 2020 / Revised: 17 February 2020 / Accepted: 21 February 2020 / Published: 25 February 2020
(This article belongs to the Section Epidemiology & Public Health)
Background: We aimed to (1) analyze time trends in the incidence and in-hospital outcomes of heart failure (HF) patients suffering Clostridioides difficile 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%; p < 0.001) and secondary diagnosis (21.12% vs. 14.76%; p < 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. View Full-Text
Keywords: Clostridium difficile infection; heart failure; in-hospital mortality; hospitalization; incidence Clostridium difficile infection; heart failure; in-hospital mortality; hospitalization; incidence
MDPI and ACS Style

Méndez-Bailón, M.; Jiménez-García, R.; Hernández-Barrera, V.; de Miguel-Díez, J.; de Miguel-Yanes, J.M.; Muñoz-Rivas, N.; Lorenzo-Villalba, N.; Carabantes-Alarcon, D.; Zamorano-León, J.J.; Astasio-Arbiza, P.; Ortega-Molina, P.; López-de-Andrés, A. Heart Failure Is a Risk Factor for Suffering and Dying of Clostridium difficile Infection. Results of a 15-Year Nationwide Study in Spain. J. Clin. Med. 2020, 9, 614. https://doi.org/10.3390/jcm9030614

AMA Style

Méndez-Bailón M, Jiménez-García R, Hernández-Barrera V, de Miguel-Díez J, de Miguel-Yanes JM, Muñoz-Rivas N, Lorenzo-Villalba N, Carabantes-Alarcon D, Zamorano-León JJ, Astasio-Arbiza P, Ortega-Molina P, López-de-Andrés A. Heart Failure Is a Risk Factor for Suffering and Dying of Clostridium difficile Infection. Results of a 15-Year Nationwide Study in Spain. Journal of Clinical Medicine. 2020; 9(3):614. https://doi.org/10.3390/jcm9030614

Chicago/Turabian Style

Méndez-Bailón, Manuel; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; de Miguel-Díez, Javier; de Miguel-Yanes, José M.; Muñoz-Rivas, Nuria; Lorenzo-Villalba, Noel; Carabantes-Alarcon, David; Zamorano-León, José J.; Astasio-Arbiza, Paloma; Ortega-Molina, Paloma; López-de-Andrés, Ana. 2020. "Heart Failure Is a Risk Factor for Suffering and Dying of Clostridium difficile Infection. Results of a 15-Year Nationwide Study in Spain" J. Clin. Med. 9, no. 3: 614. https://doi.org/10.3390/jcm9030614

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