1997. Epidemiology and Burden of Acute Infectious Gastroenteritis Among Adult Outpatient Treated in United States Hospitals
Authors: Moon Rena , Bleak Tammy C , Rosenthal Ning , Couturier Brianne , Hemmert Rachael , Timbrook Tristan T , Brown Harold , Fang Ferric C 
Published: December 2022

Abstract

Background
Little is known about the epidemiology and burden of acute infectious gastroenteritis (AIG) among adult outpatients treated in United States (US) hospitals. We assessed the demographic and clinical characteristics, common pathogens detected, healthcare resource use (HRU), and cost among adult outpatients in US hospitals.

Methods
Using large geographically diverse PINC AI Healthcare Database data during January 1, 2016–June 30, 2021, we analyzed adult patients (≥ 18-year-old) with a principal diagnosis of AIG during an outpatient visit. Patients with a history of AIG within 30 days prior to the index visit and visits for diagnostic testing or surgery were excluded. Pathogen analysis was performed among those with microbiology data available.

Results
Among 248,896 eligible patients, the mean age was 44.3 years (range 18-89+), 62.9% were female, and 68.5% were White (Table 1). Most patients visited small (48.7%, 1-299 beds), non-teaching (60.4%), and urban (77.9%) hospitals. Common comorbid conditions included hypertension (27.5%), chronic pulmonary disease (19.4%), diabetes (16.1%), and obesity (7.6%). However, 62.0% of the patients did not have any pre-existing comorbidity. Among all patients with an AIG diagnosis, only 15.3% underwent stool work-up at the hospital. The majority of patients (84.7%) were seen in the emergency room, and most (96.4%) were discharged home (Table 2). Within 30 days of discharge, &lt; 1.0% underwent ancillary abdominal/gastrointestinal diagnostic testing, 1.0% were hospitalized and 2.8% had another outpatient visit due to AIG at the same hospital. Mean cost of the index visit plus 30-day follow-up was $1,338 per patient, amounting to $333,060,182 for the total study population. Among the subgroup of patients with microbiology data available (n=12,469), common pathogens detected were Clostridium difficile (32.2%), Norovirus (6.3%), and Campylobacter spp. (4.0%). No pathogen was detected in 47.5%. Table 1.Patient, clinical, and hospital characteristics of hospital-based infectious gastroenteritis outpatients during January 1, 2016 - June 30, 2021Table 2.Outcomes of hospital-based infectious gastroenteritis outpatients during January 1, 2016 - June 30, 2021

Conclusion
Acute infectious gastroenteritis is a common and costly disease affecting adults of all ages and more females than males, including individuals either with or without baseline conditions in a hospital-based outpatient setting. Clostridium difficile was the most common pathogen detected.

Disclosures
Rena Moon, MD, MPH, Premier Inc: Employee Tammy C. Bleak, PharmD, MSc, bioMerieux: Employee of bioMerieux Ning Rosenthal, MD, PhD, MPH, Premier Inc: Employee|Premier Inc: Stocks/Bonds Brianne Couturier, PhD, bioMerieux: Employee of bioMerieux Rachael Hemmert, MSPH, bioMerieux: Employee of bioMerieux Tristan T. Timbrook, PharmD, bioMerieux: Employee of bioMerieux Harold Brown, MBA, MHA, Premier Inc: Employee Ferric C. Fang, MD, bioMerieux: Advisor/Consultant.