• Vijay Gayam, Amrendra Kumar Mandal, Chobufo Muchi Ditah, Jasdeep Sidhu, Venu Madhav Konala, Sreedhar Adapa, Srikanth Naramala, and Pavani Garlapati.
• From the Department of Internal Medicine, Interfaith Medical Center, Brooklyn, New York, the Department of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, Kentucky, the Division of Nephrology, The Nephrology Group, Fresno, California, and the Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, California.
• South. Med. J. 2020 Nov 1; 113 (11): 593-599.

ObjectivesWe aimed to determine in-hospital outcomes, length of hospital stay, and resource utilization in a contemporary cohort of Clostridioides difficile infection (CDI) and vitamin D deficiency (VDD).MethodsThe National Inpatient Sample database for 2016 and 2017 was used for data analysis using International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) codes to identify the patients with the principal diagnosis of CDI and VDD. We assessed the all-cause in-hospital mortality, morbidity, length of hospital stay (LOS), and total costs between propensity-matched groups of CDI without VDD versus CDI with VDD.ResultsWe identified 202,234 patients with CDI, 4515 of whom were patients with VDD and 197,719 of whom were without VDD. After propensity matching, there was no difference in the in-hospital mortality between the two groups (odds ratio [OR] 1.5, 95% confidence interval [CI] 0.58-4.3; P = 0.90). CDI with VDD has a higher odds of sepsis (OR 1.6, 95% CI 1.3-1.9; P = 0.0), and peritonitis (OR 1.6, 95% CI 1.4-3.8; P = 0.01). Mean LOS (5.9 ± 1.8 vs 5.4 ± 2, P < 0.01) and mean total charges ($11,500 vs $9971, P < 0.04) were higher in CDI with VDD. The factors affecting the LOS were acute coronary syndrome (P = 0.04), mechanical ventilation (P = 0.03), obesity (P = 0.004), acute kidney injury (P = 0.04), and sepsis (P = 0.05).ConclusionsIn this large cohort in a propensity-matched analysis, VDD does not increase the in-hospital mortality in CDI. VDD increases the odds of complications with a higher LOS and resource utilization. These findings may be clinically relevant to guide clinicians to routinely monitor vitamin D status and supplement in patients at risk of CDI.

18 keywords...

hide…