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Obesity Is Associated with Increased Risk of Colectomy in Inflammatory Bowel Disease Patients Hospitalized with Clostridium difficile Infection

  • Manish P. Shrestha
  • Sasha TalebanEmail author
Original Article
  • 48 Downloads

Abstract

Background

Obesity and inflammatory bowel disease (IBD) are associated with increased risk of Clostridium difficile infection (CDI). The effect of obesity on IBD course and development of complications is poorly understood. We performed this study to examine the effect of obesity on CDI-related morbidity and mortality in hospitalized patients with IBD.

Methods

We used data from the National Inpatient Sample across five study years (2010–2014) to identify patients ≥ 18 years hospitalized with both CDI and IBD. We compared the outcomes of in-hospital mortality, partial or total colectomy, hospital length of stay, and hospital charges between obese and non-obese IBD–CDI patients. Analysis included univariate and multivariate linear and logistic regression analyses.

Results

Of 304,298 hospitalized patients with IBD, 13,517 (4.4%) patients had CDI. Of these, 996 (7.4%) patients were obese. Obese IBD–CDI patients had a higher risk of colectomy (adjusted odds ratio, AOR 1.60, 95% CI 1.30–1.96; p < 0.001), longer hospital length of stay (difference 0.8 days, 95% CI 0.02–1.58; p = 0.04), and higher hospital charges (difference $11,051, 95% CI 1939–20,163; p = 0.02) than non-obese IBD–CDI patients, but no significant difference in mortality was found between the two groups.

Conclusions

Obesity is associated with a 60% increase in the risk of colectomy, longer hospital stay, and higher charges in IBD patients hospitalized with CDI. Further epidemiological and clinical studies are needed to confirm these findings.

Keywords

Clostridium difficile infection Inflammatory bowel disease Obesity In-hospital mortality Colectomy 

Notes

Acknowledgments

The authors thank Dr. Mark Borgstrom for his assistance with coding and Dr. Haiquan Li for his review of the statistical analysis.

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

10620_2018_5423_MOESM1_ESM.docx (109 kb)
Supplementary material 1 (DOCX 109 kb)
10620_2018_5423_MOESM2_ESM.docx (102 kb)
Supplementary material 2 (DOCX 102 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Arizona College of MedicineTucsonUSA
  2. 2.Division of GastroenterologyUniversity of Arizona College of MedicineTucsonUSA
  3. 3.Department of MedicineArizona Center of AgingTucsonUSA

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