Outcomes and expenditures of clostridium difficile infection in pediatric solid organ transplant recipients

PIN100 OUTCOMES AND EXPENDITURES OF CLOSTRIDIUM DIFFICILE INFECTION IN PEDIATRIC SOLID ORGAN TRANSPLANT RECIPIENTS Ling Y.L., Rascati K.L. The University of Texas at Austin, College of Pharmacy, Austin, TX, USA objeCtives: To assess outcomes of clostridium difficile infection (CDI) and the association of expenditures and CDI in pediatric solid organ transplant (SOT) recipients. Methods: Data from the 2000, 2003, 2006, and 2009 Kids’ Inpatient Database (KID) files were used to identify events with SOTrelated ICD-9-CM diagnosis codes. The data were evaluated using logistic regressions and log-linked gamma regressions. Results: The total number of pediatric SOT hospital events was 48,286. The overall prevalence of CDI for pediatric SOT hospitalizations was 1.76%. For SOT hospitalizations with CDI, inpatient mortality was 1.63%; the prevalence of transplant failure or rejection events was 27.71%; the prevalence of a colectomy was 4.86%. The median LOS was seven days; the median charge for each hospitalization was $48,409; and the median cost for each hospitalization was $17,412. The results showed that CDI was not significantly associated with inpatient mortality or transplant failure/ rejection in pediatric SOT hospitalizations, but the power to detect differences was low. SOT patients with CDI were 2.6 times more likely to have a colectomy than SOT patient without CDI (OR= 2.62, 95% CI= [1.63, 4.22], p< 0.001). The mean LOS for a SOT admission with CDI was approximately 2 times the mean LOS for a SOT admission without CDI (coefficient= 1.93, 95% CI= [1.68, 2.21], p< 0.001). The mean charges and the mean costs for a SOT admission with CDI was approximately 2 times that for a SOT admission without CDI (charges: coefficient= 2.01, 95% CI= [1.63, 2.46], p< 0.001; costs: coefficient= 1.96, 95% CI= [1.50, 2.58], p< 0.001). ConClusions: CDI diagnoses were not significantly associated with higher inpatient mortality or transplant failure/ rejection for pediatric SOT hospitalizations. But CDI was significantly associated with a higher prevalence of a colectomy, longer hospital LOS, higher charges, and higher costs.