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Impact of Clostridioides difficile infection on patient-reported quality of life

Published online by Cambridge University Press:  07 October 2021

Zheyi Han ,
Brittany Lapin ,
Kevin W. Garey ,
Curtis J. Donskey  and
Abhishek Deshpande
Zheyi Han
Affiliation:
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
Brittany Lapin
Affiliation:
Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
Kevin W. Garey
Affiliation:
University of Houston College of Pharmacy, Houston, Texas
Curtis J. Donskey
Affiliation:
Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio
Abhishek Deshpande*
Affiliation:
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio Medicine Institute Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio
*
Author for correspondence: Abhishek Deshpande, E-mail: abhishekdp@gmail.com
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Abstract

Objective:

We investigated the quality of life (QoL) of patients hospitalized with C. difficile infection (CDI).

Design:

Prospective survey study.

Setting:

US tertiary-care referral center, acute-care setting.

Participants:

Adults hospitalized with a diagnosis of CDI, defined as ≥3 episodes of unformed stool in 24 hours and a positive laboratory test for C. difficile.

Methods:

We surveyed patients from July 2019 to March 2020 using the disease-specific Cdiff32 questionnaire and the generic PROMIS GH survey. We compared differences in Cdiff32 scores among demographic and clinical subgroups (including CDI severity, CDI recurrence, and various comorbidities) using 2-sample t tests. We compared PROMIS GH scores to the general population T score of 50 using 1-sample t tests. We performed multivariable linear regression to identify predictors of Cdiff32 scores.

Results:

In total, 100 inpatients (mean age, 58.6 ±17.1 years; 53.0% male; 87.0% white) diagnosed with CDI completed QoL surveys. PROMIS GH physical health summary scores (T = 37.3; P < .001) and mental health summary scores (T = 43.4; P < .001) were significantly lower than those of the general population. In bivariate analysis, recurrent CDI, severe CDI, and number of stools were associated with lower Cdiff32 scores. In multivariable linear regression, recurrent CDI, severe CDI, and each additional stool in the previous 24 hours were associated with significantly decreased Cdiff32 scores.

Conclusions:

Patients hospitalized with CDI reported low scores on the Cdiff32 and PROMIS GH, demonstrating a negative impact of CDI on QoL in multiple health domains. The Cdiff32 questionnaire is particularly sensitive to QoL changes in patients with recurrent or severe disease.

Keywords

Clostridioides difficilequality of lifesurveypatient-reported outcomes
Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 10 , October 2022 , pp. 1339 - 1344
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION: Data from this study were presented at the 2020 Society for Medical Decision Making 42nd Annual North American Meeting, October 6–27, 2020, in Chicago, Illinois.

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