Graduation Year

2007

Document Type

Thesis

Degree

M.S.P.H.

Degree Granting Department

Public Health

Major Professor

Aurora Sanchez-Aguiano, Ph.D.

Committee Member

Donna Haiduven, Ph.D.

Committee Member

Yougui Wu, Ph.D.

Committee Member

Roger Sanderson, MA.

Keywords

Canada, CDAD, Co-morbitity, AHCA, Mortality

Abstract

Clostridium difficile, a bacterium that causes diarrhea in hospitalized patients, is on the rise in the United States as well as in other countries. This study was done to determine the extent of the problem in Florida's acute care hospitals. The Agency for Healthcare Administration (AHCA) provided data for patients discharged from Florida's acute care hospitals for the years 1998 through 2004.

This study will focus on changes in the prevalence of Clostridium difficile associated disease (CDAD) over time. The mortality and morbidity of patients that have CDAD will also be examined to show if the disease is increasing over time. Factors investigated in this study that may influence the prevalence of CDAD include gender, race, length of hospital stay, age, and the cost per patient discharged.

In Florida the prevalence of CDAD has risen from 3.41 per 1,000 discharged patients in 1998 to 8.11 per 1,000 discharged patients in 2004. The mortality increased from 9.48% for CDAD positive patients in 1998 to 10.11% for CDAD positive patients in 2004. Age plays a role in both the prevalence and mortality of this disease. In 2004 the mortality of patients who were positive for Clostridium difficile was 4.1% for those individuals that were 30-40 years old compared to 0.54% mortality for those patients in the same age group that did not have CDAD. The corresponding mortality for the patients aged 70-80 for the year 2004 was 11.1% for persons who had CDAD and 3.58% mortality for patients discharged with no CDAD.

The analysis showed that CDAD prevalence is increasing in Florida acute care hospitals. During 1998-2004 mortality rates for patients diagnosed with CDAD is also increasing. This analysis also indicates that age is a factor that increases the death rates for patients that are CDAD positive. A more concerted effort to implement hospital techniques that prevent the increasing prevalence of Clostridium difficile in Florida hospitals is recommended.

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