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Background <p>Clostridioides difficile infection (CDI) remains a significant cause of morbidity among hospitalized patients, yet contemporary data evaluating its impact in patients with colorectal cancer (CRC) receiving chemotherapy are limited. We aimed to assess the clinical outcomes associated with CDI in this population using a large national database.</p> Methods <p>We conducted a retrospective cross-sectional study using the National Inpatient Sample (NIS) from 2016 to 2021. Adult hospitalizations with a diagnosis of CRC and receipt of chemotherapy were identified using ICD-10-CM and procedural codes. CDI was defined using ICD-10-CM codes (A047.x). Survey-weighted analyses were performed to evaluate associations between CDI and in-hospital mortality, length of stay (LOS), and total hospitalization costs. Multivariable logistic and linear regression models adjusted for demographic, socioeconomic, and hospital-level characteristics.</p> Results <p>Among 7,680 weighted hospitalizations, CDI occurred in approximately 1.6% of admissions. Patients with CDI were older (mean age 70.1 vs. 62.5 years; <i>p</i> &lt; 0.01) and had higher in-hospital mortality (aOR 2.55; 95% CI, 1.45–4.48; <i>p</i> = 0.001), longer hospitalization (β 0.85; <i>p</i> &lt; 0.001), and increased costs (β 0.78; <i>p</i> &lt; 0.001). CDI occurred more frequently in patients with sepsis (5.1% vs. 1.2%; <i>p</i> &lt; 0.001) and critical illness with shock (3.2% vs. 1.6%; <i>p</i> = 0.075). Demographic and hospital-level factors showed limited association with CDI after adjustment.</p> Conclusions <p>In this nationally representative cohort of hospitalized patients with CRC receiving chemotherapy, CDI was associated with significantly increased in-hospital mortality, length of stay, and healthcare utilization. These findings underscore the substantial clinical and economic burden of CDI in this vulnerable population and highlight the importance of early recognition, prevention, and targeted management strategies.</p>

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Clinical Characteristics and Outcomes Associated with Clostridium Difficile Infection among Hospitalized Colorectal Cancer Patients Receiving Chemotherapy: a Nationwide Retrospective Analysis

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Akhil Deepak Vatvani,
  • Gilbert Lazarus,
  • Reyad Al Jabiri,
  • Ivan Damara,
  • Rama Nada,
  • Maria Albuja Altamirano,
  • Sakina Paracha,
  • Daniel Gonzalez Mosquera,
  • Pratik Patel,
  • Nehad Shabarek

摘要

Background

Clostridioides difficile infection (CDI) remains a significant cause of morbidity among hospitalized patients, yet contemporary data evaluating its impact in patients with colorectal cancer (CRC) receiving chemotherapy are limited. We aimed to assess the clinical outcomes associated with CDI in this population using a large national database.

Methods

We conducted a retrospective cross-sectional study using the National Inpatient Sample (NIS) from 2016 to 2021. Adult hospitalizations with a diagnosis of CRC and receipt of chemotherapy were identified using ICD-10-CM and procedural codes. CDI was defined using ICD-10-CM codes (A047.x). Survey-weighted analyses were performed to evaluate associations between CDI and in-hospital mortality, length of stay (LOS), and total hospitalization costs. Multivariable logistic and linear regression models adjusted for demographic, socioeconomic, and hospital-level characteristics.

Results

Among 7,680 weighted hospitalizations, CDI occurred in approximately 1.6% of admissions. Patients with CDI were older (mean age 70.1 vs. 62.5 years; p < 0.01) and had higher in-hospital mortality (aOR 2.55; 95% CI, 1.45–4.48; p = 0.001), longer hospitalization (β 0.85; p < 0.001), and increased costs (β 0.78; p < 0.001). CDI occurred more frequently in patients with sepsis (5.1% vs. 1.2%; p < 0.001) and critical illness with shock (3.2% vs. 1.6%; p = 0.075). Demographic and hospital-level factors showed limited association with CDI after adjustment.

Conclusions

In this nationally representative cohort of hospitalized patients with CRC receiving chemotherapy, CDI was associated with significantly increased in-hospital mortality, length of stay, and healthcare utilization. These findings underscore the substantial clinical and economic burden of CDI in this vulnerable population and highlight the importance of early recognition, prevention, and targeted management strategies.