Gender-Based Disparities in Clostridium Difficile Infections in the United States: A Population-Based Study

Introduction: Clostridium difficile infection (CDI) is a common hospital-acquired infection that affects older adults, leading to increased morbidity and mortality. While there is a significant body of literature examining socio-economic and ethnic disparities in the treatment of CDI, little is known about gender-based disparities. This study aims to investigate potential gender-based disparities in CDI readmissions. Methods: The present study used the Nationwide Readmissions Database (2019) to identify principal hospitalizations of adult patients with CDI. Results: The study included 64,710 index admissions, with 3,436 30-day readmissions (males = 35.2%, females = 65%). Recurrent colitis due to CDI was the most common cause of readmission for males and females (32.1% and 31.8%, respectively), followed by sepsis (20.8% and 21.2%, respectively). Males had higher rates of leaving against medical advice (AMA) (1.6% vs. 1%, P < 0.001) and inpatient mortality (1.3% vs. 1.2%, P < 0.001) for CDI readmissions compared to index admissions. However, there was no significant difference in median hospital stay and charges for both genders. There was a higher frequency of leaving AMA (1.6% vs. 1%, P < 0.001) and inpatient mortality (1.3% vs. 1.2%, P < 0.001) in 30-day readmissions compared to index admissions. In comparison, females only had a higher AMA rate (1.4% vs. 0.8%, P = 0.006) for 30-day readmissions compared to index admissions. Conclusion: Both genders have a higher AMA rate, but only males have a higher inpatient mortality for CDI readmissions than index admissions. There is no gender-based disparity between stay and hospital charges for CDI readmissions. Our study contributes to understanding CDI's impact on patient outcomes. Healthcare providers should remain aware of these potential disparities to ensure appropriate care for all patients with CDI, regardless of gender.