It is believed that Clostridium difficile infection (CDI) contributes to a prolonged of length of stay (LOS). Recent literature suggests that models previously used to determine LOS due to infection have overestimated LOS, compared to newer statistical models. Researchers in Australia sought to understand the impact that CDI has on LOS and in doing so, describe the methodological approaches used. Aim First, to investigate and describe the reported prolongation of LOS in hospitalized patients with CDI. They also aim to describe the methodologies used for determining excess LOS.
Mitchell and Gardner (2012) used an integrative review method; papers were reviewed and analyzed individually and themes were combined using integrative methods. They report that findings from all studies suggested that CDI contributes to a longer LOS in hospital. In studies that compared persons with and without CDI, the difference in the LOS between the two groups ranged from 2.8 days to 16.1 days. Potential limitations with data analysis were identified, given that no study fully addressed the issue of a time-dependent bias when examining the LOS. Recent literature suggests that a multi-state model should be used to manage the issue of time-dependent bias.
The researchers concluded that studies examining LOS attributed to CDI varied considerably in design and data collected. Future studies examining LOS related to CDI and other healthcare-associated infections should consider capturing the timing of infection in order to be able to employ a multi-state model for data analysis. Their research was published in Antimicrobial Resistance and Infection Control.
Reference: Mitchell BG and Gardner A. Prolongation of length of stay and Clostridium difficile infection: a review of the methods used to examine length of stay due to healthcare associated infections. Antimicrobial Resistance and Infection Control 2012, 1:14 doi:10.1186/2047-2994-1-14