TY - BOOK AU - Shorr, Andrew F TI - Hospital readmission with Clostridium difficile infection as a secondary diagnosis is associated with worsened outcomes and greater revenue loss relative to principal diagnosis: A retrospective cohort study SN - 0025-7974 PY - 2018/// KW - *Clostridium Infections/di [Diagnosis] KW - *Clostridium Infections/th [Therapy] KW - *Patient Readmission KW - Adolescent KW - Adult KW - Aged KW - Clostridium Infections/ec [Economics] KW - Clostridium Infections/mo [Mortality] KW - Female KW - Follow-Up Studies KW - Health Care Costs KW - Hospital Mortality KW - Humans KW - Length of Stay/ec [Economics] KW - Male KW - Middle Aged KW - Patient Readmission/ec [Economics] KW - Retrospective Studies KW - United States KW - Young Adult KW - MedStar Washington Hospital Center KW - Medicine/Pulmonary-Critical Care KW - Comparative Study KW - Journal Article KW - Multicenter Study KW - Observational Study N1 - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 N2 - Recurrent Clostridium difficile infection (rCDI) requiring rehospitalization contributes to poor outcomes, which may differ between patients hospitalized with versus for it.We performed a multicenter retrospective cohort study of rehospitalized adults surviving initial CDI hospitalization. Hospital mortality, length of stay (LOS), 30-day readmission, and mean gap between hospital costs and Diagnosis Related Group (DRG) reimbursement served as outcomes.Among the 25.7% (n = 99,175) survivors requiring rehospitalization, 36,504 (36.8%) had rCDI (14,005 [38.4%] principal diagnosis rCDI [PrCDI]). Compared with non-CDI, PrCDI, and secondary diagnosis rCDI [SrCDI] carried lower risk of death (PrCDI odds ratio [OR] 0.52; 95% confidence interval [CI] 0.46, 0.58; SrCDI OR 0.80; 95% CI 0.75, 0.85) and 30-day readmission (PrCDI OR 0.84; 95% CI 0.80, 0.88; SrCDI OR 0.97; 95% CI 0.94, 1.01), and excess LOS (PrCDI 1.8 days; 95% CI 1.7, 2.0; SrCDI 1.4 days; 95% CI 1.3, 1.5), and costs (PrCDI UR - https://dx.doi.org/10.1097/MD.0000000000012212 ER -