title: Excess Mortality Attributable to Clostridium difficile and Risk Factors for Infection in an Historic Cohort of Hospitalised Patients Followed Up in the United Kingdom Death Register.
abstract: METHODS
  We compared time from hospital admission to death in a probability sample of 100 Clostridium difficile infected cases and a probability sample of 98 non-cases admitted to an English teaching hospital between 2005 and 2007 with follow up in the UK national death register using survival analysis.
  
  
  RESULTS
  Clostridium difficile infection was associated with a 50% increased risk of death (Hazard Ratio 1.51 (95% CI: 1.05-2.19 p = 0.03) at between five to eight years in Cox Regression analysis adjusting for age, sex, Charlson comorbidity index, diagnosis of a malignant condition and insertion of a nasogastric tube during admission. Acquisition of Clostridium difficile infection was independently associated with an almost six fold higher odds of being admitted with a diagnosis of infection of any other type (OR 5.79 (2.19, 15.25) p<0.001).
  
  
  CONCLUSIONS
  Our results strongly support continued priority being given to improve prevention and treatment of Clostridium difficile infection in the English National Health Service particularly in patients admitted with an infection. Our results may be applicable to other health systems.
authors.affiliation: Cambridge Institute of Public Health, Public Health England, National Infection Service, Field Epidemiology Service, Cambridge, United Kingdom.|Clinical Microbiology and Public Health Laboratory (Public Health England), Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Reacher
authors.affiliation: Statistics unit, Statistics, Modelling and Economics Department, Public Health England, National Infection Service, Colindale, London, United Kingdom.
authors.forename: Neville Q
authors.initials: NQ
authors.lastname: Verlander
authors.affiliation: Cambridge Institute of Public Health, Public Health England, National Infection Service, Field Epidemiology Service, Cambridge, United Kingdom.
authors.forename: Iain
authors.initials: I
authors.lastname: Roddick
authors.affiliation: Clinical Microbiology and Public Health Laboratory (Public Health England), Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Trundle
authors.affiliation: Clinical Microbiology and Public Health Laboratory (Public Health England), Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Brown
authors.affiliation: Clinical Microbiology and Public Health Laboratory (Public Health England), Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Farrington
authors.affiliation: Department of Medical Microbiology, Ipswich Hospital, Ipswich, United Kingdom.
authors.forename: Philip
authors.initials: P
authors.lastname: Jones
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000382:microbiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D012042:Registries; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology