High mortality, costs with C. difficile after spine surgery

(HealthDay)—For patients undergoing lumbar spine surgery, Clostridium difficile (C. difficile) infection is associated with longer, more expensive hospital stays, and increased mortality, according to a study published in the Sept. 1 issue of Spine.

Branko Skovrlj, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the incidence, comorbidities, and impact on health care resources of C. difficile infection after lumbar spine surgery. Patients were identified from the Nationwide Inpatient Sample for 2002 to 2011.

The researchers found that the incidence of C. difficile infection was 0.11 percent among patients undergoing lumbar spine surgery. Patients infected with C. difficile were more likely to be older at baseline, and have comorbidities. The odds of postoperative infection were increased for lumbar fusion (P = 0.0001) and lumbar fusion revision (P = 0.0003). Decreased odds of infection were seen for small hospital size (odds ratio [OR], 0.5), while urban hospitals were associated with increased infection odds (OR, 2.14). The odds of acquiring postoperative infection were increased among uninsured patients (OR, 1.62) and patients with Medicaid (OR, 1.33). Hospital length of stay, hospital charges, and inpatient mortality were all significantly increased with C. difficile.

"Great care should be taken to avoid C. difficile colitis in patients undergoing lumbar spine surgery because it is associated with longer hospital stays, greater overall costs, and increased inpatient mortality," write the authors.

Relevant financial activities outside the submitted work were disclosed: consultancy, grants,
payment for lectures, royalties.