O143 SPARC (SECRETED PROTEIN ACIDIC AND RICH IN CYSTEINE) DEFICIENCY PROTECTS FROM CONCANAVALIN A-INDUCED HEPATITIS IN MICE

Abstract

Background and Aims: Infection in alcoholic hepatitis (AH) greatly increases mortality. No data exists regarding the impact of Clostridium difficile infection (CDI), an increasingly incident and virulent infection, in patients with AH. The study aims were to identify whether AH is an independent risk factor for CDI and to determine the impact of CDI on mortality, length of stay (LOS), and total hospital charges in this population. Methods: We performed a cross-sectional analysis using the Nationwide Inpatient Sample (NIS) dataset, years 2008–2011. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify subjects with AH. We used multivariable logistic regression to determine predictors of CDI in hospitalized patients and risk factors for mortality in patients with AH. Among patients with AH, the impact of CDI on LOS was evaluated using negative binomial regression, while poisson regression was used to determine the impact of CDI on hospital charges. Results: Of 10,939 patients with AH, 177 (1.62%) had CDI. In logistic regression analysis, AH independently predicted CDI (adj OR=1.61, p < 0.001), adjusting for other risk factors for CDI. Patients with both AH and CDI had increased odds of inpatient mortality (adj OR=1.75, p = 0.04), greater predicted LOS (10.63 days vs 5.75 days, p < 0.001) and higher predicted inpatient hospital charges ($36,924.30 vs $29,136.58, p < 0.001), than AH patients without CDI. Conclusions: AH is a risk factor for CDI. Furthermore, CDI leads to greater mortality and economic healthcare burden in this population. Vigilance should be maintained for suspecting and testing for CDI in AH.