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Table 1 Overview of selected references that assessed economic burden attributable to CDI by type of CDI considered in the US

From: Cost of hospital management of Clostridium difficile infection in United States—a meta-analysis and modelling study

ID Reference State, city Data collection period Type of CDI Population Sample size (Total) Sample size (CDI cases) Age of CDI patients
Mean ± SD or (Range), years
CDI definition (short) Quality assessment Statistical methodology Data source
1 Ali 2012 [27] National 2004–2008 Comp. Liver transplant 193,714 5159 >18 ICD-9; 008.45 (Primary Diagnosis-PD, Secondary Diagnosis-SD) Low No matching; no regression Nationwide Inpatient Sample (NIS)
2 Ananthakrishnan 2008 [28] National 2003 Comp. IBD 124,570 2804 >18
CDI: 73a;
CDI-IBD: 54a
ICD-9; 008.45 (PD) Medium No matching; regression NIS
3 Arora 2011 [29] Houston 2007–2008 Req. General 85 85 Horn’s Index Score 1&2: 64 ± 19; Horn’s Index Score 3&4: 65 ± 15 Toxin assay Low No matching; no regression St Luke’s Episcopal Hospital
4 Bajaj 2010 [30] National National: 2005
Tertiary: 2002–2006
Both Cirrhosis 83,230 1165 CDI: 69 ± 20; Cirrhosis-CDI: 61 ± 15 ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
5 Campbell 2013 [31] National 2005–2011 Comp. General NR 4521 Renal impairment 72.9 ± 13.4; Advanced Age: 78.7 ± 7.4; Cancer/BMT 69.2 ± 14.0; IBD 61.2 ± 18.3; Cabx exposure 61.2 ± 14.8 Toxin assay High Matching; regression Health Facts electronic health record (HER) database
6 Damle 2014 [14] National 2008–2012 Comp. Colorectal surgery 84,648 1266 >18
63 ± 17
ICD-9; 008.45 (PD, SD) Medium No matching; regression University Health System Consortium database
7 Dubberke 2008 [33] Missouri 2003–2003 Both Non-
Surgical
24,691 439 67(18–101) a Toxin assay High Matching; regression Barnes-Jewish Hospital Electronic record
8 Dubberke 2014 [2, 34, 71] Missouri 2003–2009 Both Recurrent CDI 3958 421 >18 Toxin assay or clinical diagnosis for recurrent CDI High Matching; regression Barnes-Jewish Hospital Electronic record
9 Egorova 2015 [35] National 2000–2011 Comp. Vascular surgery NR 2808 68.4 ICD-9; 008.45 (PD, SD) High Matching: regression NIS
10 Flagg 2014 [36] National 2004–2008 Comp. Cardiac surgery 349,112 2581 All age band ICD-9; 008.45 (SD) High Matching: regression NIS
11 Fuller 2009 [37] Maryland and California 2007–2008 for Maryland 2005–2006 for California Comp. General 3760 3760 Clinical diagnosis Medium No matching; regression Health Services and Cost Review Commission, Maryland; The Office of State-wide Planning and Development, California
12 Glance 2011 [38] National 2005–2006 Comp. Trauma 149,648 768 69(45–82) a Clinical diagnosis Medium No matching; regression NIS
13 Jiang 2013 [39] Rhode Islands 2010–2011 Comp. General 225,999 6053 >18
71.4 ± 15.8
ICD-9; 008.45 (SD) Medium Matching; no regression Rhode Island’s 11 acute-care hospitals
14 Kim 2012 [40] National 2001–2008 Comp. Cystectomy 10,856 153 >18
68.49 ± 10.52
ICD-9 ; 008.45 (SD) Medium No matching; regression NIS
15 Kuntz 2012 [41] Colorado 2005–2008 Comp. General 3067 3067 All age band, Outpatient 62.8 ± 19.4;
Inpatient 69.9 ± 16.3
ICD-9 + toxin assay Medium No matching; regression Kaiser Permanente Colorado and Kaiser Permanente Northwest members
16 Lagu 2014 [42] Massachusetts, Boston one hospital 2004–2010 Comp. Sepsis 218,915 2348 70.9 ± 15.1 ICD-9; 008.45 (PD, SD) + toxin assay Medium Matching; no regression Baystate Medical Center (Premier Healthcare Informatics database, a voluntary, fee-supported database)
17 Lameire 2015 National 2002–2009 Comp. Cardiac surgery 512,217 421,294 >40
CABG 65.4 ± 10.5
VS 66.1 ± 12.3
ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
18 Lawrence 2007 [44] Missouri 1997–1999 Both ICU 1872 76 Primary 68.9 (34–93)
Secondary 58.7 (16–91)
Toxin assay Medium No matching; regression A 19-bed medical ICU in a Midwestern tertiary care referral center.
19 Lesperance 2011 [45] National 2004–2006 Comp. Elective colonic resections 695,010 10,077 >18
All 69.8; Surgery-CDI 68.7
ICD-9; 008.45 (SD) Medium No matching; regression NIS
20 Lipp 2012 [46] New York 2007–2008 Comp. General 4,853,800 3883 >17 ICD-9; 008.45 (SD) Medium No matching; regression - The SPARCS database- acute care non-federal hospitals in New York State
21 Maltenfort 2013 [47] National 2002–2010 Both Arthroplasty NR NR All age band ICD-9; 008.45 (PD, SD) Low No matching; no regression NIS
22 McGlone 2012 [48] National 2008 Comp. General NR NR >65 ICD-9; 008.45 (SD) Low No matching; no regression Decision tree model
23 Nguyen 2008 [49] National 1998–2004 Comp. IBD 527,187 2372 47.4 ± 0.2 ICD-9; 008.45 (secondary diagnosis) Medium No matching; regression NIS
24 Nylund 2011 [50] National 1997,2000, 2003,2006 Both Children 10,495,728 21,274 CDI 9.5 ± 0.07(SEM) ICD-9; 008.45 (PD, SD) High Matching: regression Healthcare Cost and Utilization Project Kids’Inpatient Database
25 O’Brien 2007 [51] Massachusetts 1999–2003 Req. General 3692 1036 Primary 70 ± 17.6; Secondary 70 ± 17.2 ICD-9; 008.45 (PD, SD) Low No matching; no regression Massachusetts hospital discharge data
26 Pakyz 2011 [52] National 2002–2007 Comp. General 30,071 10,857 CDI 61 ± 17 ICD-9; 008.45 (SD) High Matching; regression University Health System Consorsoum (UHC)
27 Pant 2012 [53] National 2009 Both Organ transplant (OT) 244,955 6451 >18,
OT-CDI 58 ± 16 a; CDI-only 73 ± 22 a
ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
28 Pant 2012 (2) [54] National 2009 Both Renal disease 184,139 5151 >18,
ESRD + CDI 66 ± 14 CDI ONLY 70 ± 17
ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
29 Pant 2013 [55] National 2009 Both Children with IBD 12,610 447 <20,
15.1 ± 4.1
ICD-9; 008.45 (PD, SD) Medium No matching; regression The Healthcare Cost and Utilization Project Kids’ Inpatient Database (HCUP-KID)
30 Peery 2012 [56] National From 2009 Req. General 110,533 110,533 All age band ICD-9; 008.45 (PD) Low No matching; no regression National Ambulatory Medical Care Survey (NAMCS) and NIS
31 Quimbo 2013 [57] National 2005–2010 Comp. High Risk subgroups 21,177 26,620 >18
67.5 ± 17.6
ICD-9; 008.45 (PD, SD) High Matching: regression HealthCare Integrated Research Database
32 Reed 2008 Pennsylvania 2002–2006 Comp. High Risk subgroups 9164 524 >17 Hospital acquired CDAD Low No matching; no regression A large academic community hospital
33 Sammons 2013 [59] National 2006–2011 Both Children 13,295 4447 1–18
6 (2–13) a
ICD-9; 008.45 (PD, SD) + toxin assay High Matching; regression Free-standing children’s hospitals via the Paediatric Health Information System (PHIS)
34 Singal 2014 [60] National 2007 Comp. Cirrhosis 89,673 1444 All age band ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
35 Song 2008 [61] Maryland 2000–2005 Both General 9025 630 >18
unmatched 57.6 matched 60.3
Toxin assay High Matching; regression The Johns Hopkins hospital
36 Stewart 2011 [62] National 2007 Both General 82,214 41,207 All age band,
70
ICD-9; 008.45 (PD, SD) Medium Matching; no regression NIS
37 Tabak 2013 [63] Pennsylvania 2007–2008 Comp. General 77,257 255 All 64.8 ± 17.6
CDI 71.1 ± 14.8
Toxin assay High Matching; regression Six Pennsylvania hospitals via a clinical research database
38 VerLee 2012 Michigan 2002–2008 Req. General 517,413 517,413 All age band ICD-9; 008.45 (PD) Low No matching; no regression All Michigan acute care hospitals
39 Wang 2011 [65] Pennsylvania 2005–2008 Both General 7,227,788 78,273 All age band ICD-9; 008.45 (PD, SD) High Matching; regression The Pennsylvania Health Care Cost Containment Council (PHC4) database
40 Wilson 2013 [66] National 2004–2008 Comp. Ileostomy 13,245 217 All age band ICD-9; 008.45 (SD) High Matching; regression NIS
41 Zerey 2007 [67] National 1999–2003 Both Surgical 1,553,597 8113 All age band
70 am
ICD-9; 008.45 (PD, SD) Medium No matching; regression NIS
42 Zilberberg 2009 [68] National 2005 Both Prolonged acute mechanical ventilation 64,910 3468 >18
66.7 ± 15.9
ICD-9; 008.45 (PD, SD) Medium Matching; no regression NIS
  1. Abbreviations: NR not reported, IBD inflammatory bowel disease, LOS length of stay, ICU intensive care unit, retrosp. retrospective, Comp. complicating, Req. requiring, both requiring and complicating, PD primary diagnosis, SD secondary diagnosis
  2. a Median (Range)