P4287 - Chronic Kidney Disease as a Predictor of Mortality in Hospitalized Inflammatory Bowel Disease Patients With Clostridium difficile Infection

Joelle Sleiman, MD¹, Taqi Rizvi, DO¹, Mark Tawfik, DO¹, Faris Qaqish, MD¹, Suzanne El-Sayegh, MD², Jean M. Chalhoub, MD^1
1Staten Island University Hospital, Northwell Health, Staten Island, NY; ²Staten Island University Hospital, Staten Island, NY

Introduction: Clostridioides difficile infection (CDI) leads to significant morbidity and mortality in hospitalized patients. We aim to investigate whether chronic kidney disease (CKD) or end-stage renal disease (ESRD) are predictors of mortality in admitted patients with CDI, and whether the presence of inflammatory bowel disease (IBD) has any impact on the mortality rate.

Methods: The data of 133,099 hospitalized patients with CDI was analyzed from the National Inpatient Sample (NIS) database from 2016-2018. Baseline risk factors were identified using ICD-10 codes. Propensity score matching was used to match CKD/ESRD patients with patients without kidney disease based on age. A logistic regression model established the relationship between variables and adjusted for underlying risk factors. The primary endpoint was all cause mortality among hospitalized patients with CDI, particularly those with IBD.

Results: Our cohort included 133,099 hospitalized patients with CDI, among whom 20,700 (15.6%) had CKD, 12,178 (9.1%) had ESRD and 6,104 (4.6%) had IBD. The mean age was 74, 63, and 63 years (p < 0.001) in patients with CKD, ESRD, and those without kidney disease, respectively. CDI patients with ESRD had a higher proportion of males (50.3%) compared to those with CKD and without kidney disease (45.9% and 40.8%) respectively (p < 0.001). Propensity score matching was performed, and the patients were matched on age, resulting in an exact match for 32,878 patients. Logistic regression analysis showed that in CDI patients with IBD, CKD was associated with a statistically insignificant trend towards a higher all-cause mortality rate as compared to CDI patients without IBD [Odds ratio (OR), 1.682 vs Odds ratio, 1.229, P > 0.05]. However, ESRD patients had a significantly higher all-cause mortality rate (Odds ratio, 3.738, 95% CI [2.175 – 6.425]) among hospitalized CDI patients with IBD compared to those without IBD (Odds ratio, 1.612, 95% CI [1.486 – 1.749 ]) (P < 0.001).

Discussion: Kidney disease, particularly ESRD, is associated with a significant increase in mortality in CDI patients with IBD compared to those without IBD. These findings highlight the importance of aggressive CDI management in patients with IBD and ESRD.


Disclosures:


Joelle Sleiman, MD¹, Taqi Rizvi, DO¹, Mark Tawfik, DO¹, Faris Qaqish, MD¹, Suzanne El-Sayegh, MD², Jean M. Chalhoub, MD¹. P4287 - Chronic Kidney Disease as a Predictor of Mortality in Hospitalized Inflammatory Bowel Disease Patients With <i>Clostridium difficile</i> Infection, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.