| Title |
Post‐hospitalization Treatment Regimen and Readmission for C. difficile Colitis in Medicare Beneficiaries
|
|---|---|
| Published in |
World Journal of Surgery, July 2017
|
| DOI | 10.1007/s00268-017-4139-8 |
| Pubmed ID | |
| Authors |
Charles M. Psoinos, Courtney E. Collins, M. Didem Ayturk, Frederick A. Anderson, Heena P. Santry |
| Abstract |
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. We hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. We queried a 5% random sample of Medicare claims (2009-2011 Part A and Part D; n = 864,604) for hospitalizations with primary or secondary diagnosis of CDI. We compared demographics, comorbidities, and post-discharge CDI treatment (no CDI treatment, oral metronidazole only, oral vancomycin only, or both) between patients readmitted with a primary diagnosis of CDI within 90 days and patients not readmitted for any reason using univariate tests of association and multivariable models. Of 7042 patients discharged alive, 945 were readmitted ≤90 days with CDI (13%), while 1953 were not readmitted for any reason (28%). Patients discharged on dual therapy had the highest rates of readmission (50%), followed by no post-discharge CDI treatment (43%), vancomycin only (28%), and metronidazole only (19%). Patients discharged on only metronidazole (OR 0.28) or only vancomycin (OR 0.42) had reduced odds of 90-day readmission compared to patients discharged on no CDI treatment. Patients discharged on dual therapy did not vary in odds of readmission. Thirteen percent of patients discharged with CDI are readmitted within 90 days. Patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse. Half of patients requiring dual therapy required readmission, suggesting patients with symptoms severe enough to warrant discharge on dual therapy may benefit from longer hospitalization. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 10 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 10 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 2 | 20% |
| Student > Bachelor | 2 | 20% |
| Student > Doctoral Student | 1 | 10% |
| Student > Ph. D. Student | 1 | 10% |
| Student > Master | 1 | 10% |
| Other | 0 | 0% |
| Unknown | 3 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 4 | 40% |
| Nursing and Health Professions | 2 | 20% |
| Veterinary Science and Veterinary Medicine | 1 | 10% |
| Unknown | 3 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 July 2017.
All research outputs
#15,473,755
of 22,994,508 outputs
Outputs from World Journal of Surgery
#3,061
of 4,258 outputs
Outputs of similar age
#199,483
of 316,999 outputs
Outputs of similar age from World Journal of Surgery
#60
of 91 outputs
Altmetric has tracked 22,994,508 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,258 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
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We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.