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Impaired Quality of Life, Work, and Activities Among Adults with Clostridium difficile Infection: A Multinational Survey.

Abstract：

BACKGROUND:Evidence of humanistic detriments of Clostridium difficile infection (CDI) remains limited. AIMS:To assess humanistic burden associated with CDI. METHODS:Self-reported National Health and Wellness Survey data between 2013 and 2016 were analyzed for the USA, five European countries, China, and Brazil. Outcome measures included SF-36v2® for health-related quality of life (HRQoL) and Work Productivity and Activity Impairment questionnaire. Respondents (≥ 18 years old) were classified as (1) currently treated doctor-diagnosed CDI (C-CDI), (2) doctor-diagnosed prior CDI (P-CDI), or (3) never experienced CDI (NO-CDI). Regression modeling assessed the association between CDI status and outcomes, adjusting for potential confounders. RESULTS:Of 352,780 respondents, 299, 2111, and 350,370 met the criteria for C-CDI, P-CDI, and NO-CDI, respectively, with 45% of the total from the USA. C-CDI and P-CDI respondents were older, were less often employed and had more comorbidities than those with NO-CDI. After adjustment for covariates, C-CDI and P-CDI had significantly lower HRQoL relative to NO-CDI for mental (MCS 39, 43 vs. 46) and physical (PCS 39, 41 vs. 46) component summary scores, and health utility (SF-6D 0.58, 0.64 vs. 0.71) (all p < 0.05), meeting common thresholds for minimally important differences. Those with C-CDI and P-CDI reported missing more work (21, 16 vs. 8%), greater impairment while working (43, 34 vs. 22%), and more activity impairment (61, 49 vs. 34%) than those with NO-CDI (all p < 0.05), respectively. CONCLUSIONS:CDI is associated with meaningfully worse HRQoL and greater impairment to work and activities compared with NO-CDI. The impairment directly attributable to CDI requires further evaluation.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Heinrich K,Harnett J,Vietri J,Chambers R,Yu H,Zilberberg M

doi

10.1007/s10620-018-5222-1

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

2864-2873

issue

11

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-018-5222-1

journal_volume

63

pub_type

杂志文章,多中心研究

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