Case fatality of hospital acquired diarrhoea- retrospective study
Research type
Research Study
Full title
Case fatality rate of healthcare associated diarroea - an observational retrospective study
IRAS ID
219040
Contact name
TImothy D Planche
Contact email
Sponsor organisation
St Georges University Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 5 months, 1 days
Research summary
Diarrhoea is common among hospitalised patients, however surprisingly little is known about the role of episodic diarrhoea as predictor of mortality, length of hospital stay and associated costs. There are several causes of healthcare-associated diarrhoea, inducing medications, enteral feeding and other underlying diseases. Much research in this field has been dedicated to better understand healthcare-associated diarrhoea due to Clostridium difficile infection (CDI) which accounts for less than 20% of cases (Polage, 2012).
In a previous study, we assessed patient outcome using testing methods – cytotoxicity assay (CTA) and cytotoxigenic culture (CT) – for Clostridium difficile (Planche, 2013).
90% of samples submitted had no evidence of CDI. In this population of patients, which were negative for both CT and CTA, the 30-day all-cause mortality was 9%.
In this study, we are looking to investigate whether inpatient diarrhoea of unknown cause is associated with an increased case fatality rate and to identify contributory risk factors. The retrospective analysis will examine existing, routinely available patient data from the previous study (IRAS ID: 55398), including age, sex, dates of admission and discharge, blood tests within 3 days of faecal samples from the period of October 2010 to September 2011. This database will be compared to the Patient Level Information and Costing Systems (PLICS) for the same time period at St George’s University Hospital NHS Foundation Trust is a major teaching hospital . By matching case-controls by !CD10 codes, we will examine Healthcare Resource Groups to compare diagnoses, case fatality, length of stay and cost between patients with non-CDI healthcare-associated diarrhoea and inpatients with no episodes of diarrhoea. Further analysis of existing laboratory records will be undertaken to quantify infectious causes from samples collected for the previous analysis. Through this study we hope to address the evidence gap in inpatient case fatality in patients with non-CDI healthcare-associated diarrhoea.REC name
East of Scotland Research Ethics Service REC 2
REC reference
17/ES/0065
Date of REC Opinion
16 May 2017
REC opinion
Favourable Opinion