Spine surgeon researchers recently published a study about Clostridium difficile colitis in patients who undergo lumbar spine surgery in the journal Spine.
The researchers examined the Nationwide Inpatient Sample from 2002 to 2011 and included patients who underwent lumbar spine surgery for degenerative diseases. They examined the incidence of C. difficile — an infection increasing during hospitalization that has a negative impact on patient outcomes and increases healthcare costs.
The researchers found:
1. There was 0.11 percent C. difficile infection rate among the patients. Lumbar fusion and revision lumbar fusion increased the odds of postoperative infection.
2. Patients more likely to acquire the infection include:
• Older patients over the age of 65.2 years
• Patients who have diabetes with chronic complications
• Neurological complications
• Congestive heart failure
• Pulmonary disorders
• Coagulopathy
• Renal failure
3. Patients undergoing the procedure at smaller hospitals had decreased odds of acquiring the infection.
4. Patients who were uninsured and patients with Medicare had higher odds of acquiring the infection.
5. C. difficile extended the hospital stay by eight days. Hospital charges for patients with C. difficile increased two-fold, and inpatient mortality was up to 4 percent from 0.11 percent.
"C. difficile infection after lumbar spine surgery carries a 36.4-fold increase in mortality and costs approximately $10,658,646 per year to manage," according to the study authors. "These data suggest that greater care should be taken to avoid C. difficile colitis in patients undergoing lumbar spine surgery because it is associated with longer hospital stays, greater overall costs and increased inpatient mortality."