Advertisement
Post-Operative Clostridium difficile Infection Among Veterans Health Administration Patients

Post-Operative Clostridium difficile Infection Among Veterans Health Administration Patients

Recent research has shown that Clostridium difficile infection (CDI) is a growing cause of morbidity and mortality in the United States and is associated with longer hospital lengths of stay (LOS) and higher hospital costs. “CDI has also been shown to be a significant complication for surgical patients,” says William Gunnar, MD, JD. Data show that the healthcare–associated burden of CDI is increasing among surgical patients and varies among types of surgery. Among surgical patients, CDI has been linked to longer mechanical ventilation, longer ICU and hospital LOS, and higher mortality. The 134 Veterans Health Administration (VHA) Surgery Programs throughout the U.S. perform an estimated 400,000 surgical procedures each year. In 2007, the VHA modified the established VA Surgical Quality Improvement Program (VASQIP) to begin  collecting 30-day postoperative CDI data from eligible non-cardiac surgical procedures. For a retrospective observational study published in JAMA Surgery, Dr. Gunnar and colleagues documented CDI incidence in the VHA from fiscal year 2010 through 2013 across different surgical procedures. They also identified risk factors associated with CDI and determined the impact of CDI on postoperative mortality, morbidity, and hospital LOS.   Examining New Data Results of the study showed that the postoperative CDI rate was 0.4% per year, unchanged throughout the study period, and varied by the VHA Surgery Program and surgical specialty. The 30-day CDI rates were higher in emergency procedures, operations with greater complexity and higher relative value units, and those with a contaminated or infected wound classification. Patients with postoperative CDI were significantly older, were more frequently hospitalized after surgery (59.9% vs 15.4%), and had longer preoperative hospital LOS (9.1 days vs 1.9...
[ HIDE/SHOW ]