S2051 Clinical Outcomes of African American Patients With Clostridioides difficile Infection: An 8-Year Retrospective Cohort Study

Introduction: Clostridioides difficile (CD) is a spore-forming, toxin-producing bacterium that causes diarrhea and colitis, often in hospitalized or immunocompromised individuals. Although CD affects patients across all racial and ethnic groups, studies suggest that clinical outcomes may differ by race due to variations in underlying health conditions, healthcare access, and systemic inequities. Despite this, there is a lack of detailed data focusing specifically on African American patients. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these patients. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2015 to 2022. The NIS searched for hospitalizations of adult African American patients with documented CD infections using the International Classification of Diseases, Tenth Revision codes. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. SPSS software was used for statistical analysis. Results: This study included 402,061 with CD infection, of which 48,563 (12.1%) patients were female. The inpatient mortality analysis from the dataset reveals that 3,453 African American patients with CD infection died during hospitalization, accounting for approximately 14.3% of all inpatient deaths (24,068 total deaths). Multivariate regression showed that African American patients with CD infection had higher inpatient mortality when compared to patients of other races (OR 1.167, CI 1.161–1.174, P < 0.001). On secondary analysis, it has shown that African Americans with CD had higher odds of having shock of any type (OR 1.179, CI 1.170-1187, P < 0.001), vasopressor use (OR 1.182, CI 1.172-1.192, P < 0.001), and acute kidney failure (OR 1.149, CI 1.147-1.152, P < 0.001). Conclusion: In this nationally representative population-based retrospective cohort study, African American patients had higher mortality and worse outcomes among patients who are diagnosed with an infection with CD. These findings suggest that race may be an independent risk factor for worse outcomes in CD infection. Further investigation is warranted to explore potential biological, clinical, or healthcare access-related factors contributing to this disparity.