P4030 - The Association Between Clostridium difficile Infection and Different Subclasses of Body Mass Index: A Nationwide Analysis

Vikash Kumar, MD¹, Praneeth Bandaru, MD¹, Vijay Gayam, MD¹, Dhir Gala, BS², Naresh kumar, MD¹, Arnold Forlemu, MD, MPH¹, Fnu Vikash, MD³, Saigopal R. Gujjula, ⁴, Hamsika Moparty, MD¹, Vinaya Gaduputi, MD⁵, Madhavi Reddy, MD^1
1Brooklyn Hospital Center, Brooklyn, NY; ²American University of the Caribbean School of Medicine, Plainview, NY; ³Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY; ⁴American University of Antigua, Coolidge, Saint John, Antigua and Barbuda; ⁵Blanchard Valley Health System, Findlay, OH

Introduction: Clostridium difficile infection (CDI) is a healthcare-associated infection that is associated with significant morbidity and mortality. A number of factors, including the use of antibiotics, advanced age, and comorbidities, increase the risk of CDI. However, research on the effects of body mass index (BMI) on CDI outcomes is not well studied. Conversely, lower BMI has been associated with worse infection outcomes, including higher mortality rates. The aim of this study is to investigate the effects of BMI on outcomes of CDI in hospitalized patients.

Methods: A retrospective analysis was performed by utilizing the NIS database 2016 - 2020 and the International Classification of Diseases, Tenth Revision codes to identify the patients > 18 years old with CDI. We categorized BMI into four different categories, category I (19.9 or less), category II (20-29.9), category III (30-39.9), and category IV ( > 40) using appropriate ICD-10-CM codes. Multivariable regression analyses were performed adjusting for demographics, hospital-level characteristics, and relevant comorbidities

Results: A total of 854,194 patients with CDI were identified in the year 2016 to 2020. Among these cases, different categories were identified: 56,055 patients (6.5%) were in category I, 59,289 patients (6.9%) into category II, 52,195 patients (6.1%) into category III, and 48,724 patients (17.7%) into category IV. Multivariate analysis demonstrated that patients in category IV had a significantly higher odds of mortality compared to other BMI subgroups (OR = 1.16, 95% CI: 1.07-1.29, p-value < 0.00). Additionally, patients in category I also exhibited increased odds of mortality (OR = 1.72, 95% (CI): 1.46-2.02; p-value < 0.00). Further, category IV patients displayed elevated odds of comorbidities such as hypertension (OR = 1.44, 95% CI: 1.40-1.48; p < 0.001), diabetes (OR = 1.19, 95% CI: 1.16-1.22; p < 0.001), and CKD (OR = 1.10, 95% CI: 1.06-1.15; p < 0.001) when compared to other BMI subgroups.

Discussion: The results revealed that both low BMI (< 20) and high BMI ( >40) were associated with higher mortality rates from CDI. The relationship between extremely low or high BMI values and CDI mortality that has been observed emphasizes the significance of taking BMI into account as a risk factor and potential prognostic indicator in CDI management. Further research is warranted to unravel the underlying mechanisms and explore potential interventions to optimize outcomes in CDI patients with extreme BMI values.CKD

Disclosures:


Vikash Kumar, MD¹, Praneeth Bandaru, MD¹, Vijay Gayam, MD¹, Dhir Gala, BS², Naresh kumar, MD¹, Arnold Forlemu, MD, MPH¹, Fnu Vikash, MD³, Saigopal R. Gujjula, ⁴, Hamsika Moparty, MD¹, Vinaya Gaduputi, MD⁵, Madhavi Reddy, MD¹. P4030 - The Association Between Clostridium difficile Infection and Different Subclasses of Body Mass Index: A Nationwide Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.