e18538 Background: Clostridium difficile infection (CDI) is a common complication following hematopoietic stem cell transplant in adults and is associated with substantial morbidity, and mortality. Despite this association, the first 90 days readmission rates and characteristics are poorly characterized. Objective: Utilizing the Nationwide Readmission Database (HCUP-NRD); we intended to analyze rates, predictors and hospitalization cost of CDI readmission after Hematopoietic Stem Cell Transplant (HSCT) in adults. Methods: Adult patients admitted after HSCT with at least 3 months of follow-up were included for analysis using administrative claim codes for CDI in the 2014 Nationwide Readmission Database. According to HSCT type, patients were stratified to either Umbilical Cord Blood Transplant (UCBT) or Bone Marrow Transplant (BMT) (autologous and allogenic). We subsequently evaluated for CDI readmission by day 90. Results: A total of 17,412 adult patients met the inclusion criteria, including 1.3 % that received UCBT, 98.7% that received BMT. All-causes readmission rate was 32.7% (5695/17412) and CDI readmission rate was 7.9% (450/5695). The median age was 60 years, 56.2% were male, median length of stay was 8 days and the median time lapsed after transplant discharge and CDI readmission was 28 days. The most common payer was private insurance at 57.6%. The median cost per CDI admission was $62,125 with net total cost $15.3 million. Conclusions: (1) CDI 90-day readmission rate among adult patients treated with HSCT is a significant morbidity and associated with considerable cost. (2) Further studies are warranted to evaluate factors that can contribute to decreased rate of CDI readmissions following HSCT.
Evaluation of the Pharmacokinetics and Efficacy of a Busulfan Test Dose in Adult Patients Undergoing Myeloablative Stem Cell Transplant
